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Predictors of chronic post-traumatic stress disorder

A prospective study

Published online by Cambridge University Press:  02 January 2018

Sara A. Freedman ,
Dalia Brandes ,
Tuvia Peri  and
Arieh Y. Shalev
Sara A. Freedman
Affiliation:
Center for Traumatic Stress, Hadassah University Hospital, Jerusalem, Israel
Dalia Brandes
Affiliation:
Center for Traumatic Stress, Hadassah University Hospital, Jerusalem, Israel
Tuvia Peri
Affiliation:
Center for Traumatic Stress, Hadassah University Hospital, Jerusalem, Israel
Arieh Y. Shalev*
Affiliation:
Center for Traumatic Stress, Hadassah University Hospital, Jerusalem, Israel
*
Dr A. Shalev, Department of Psychiatry, Hadassah University Hospital, PO Box 12000, Jerusalem, 91120, Israel. Tel: 972-2-677184; Fax: 972-2-6434434; e-mail: [email protected]
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Abstract

Background

Most individuals who, shortly after trauma, express symptoms of post-traumatic stress disorder (PTSD) recover within one year of their traumatic experiences. In contrast, those who remain ill for one year rarely recover completely. The early identification of the latter is, therefore, very important.

Aims

To prospectively evaluate predictors of PTSD at four months and one year.

Method

We followed 236 trauma survivors recruited from admissions to a general hospital's emergency room for four months, at which point 41 (17.4%) met diagnostic criteria for PTSD. Twenty-three of these individuals, and 39 individuals without PTSD at four months, were assessed again at one year.

Results

Depressive symptoms were the best predictors of PTSD at both time points. Intrusive symptoms and peri-traumatic dissociation were better at predicting four-month PTSD than one-year PTSD.

Conclusions

The occurrence of depression during the months that follow a traumatic event is an important mediator of chronicity in PTSD.

Type
Papers
Information
The British Journal of Psychiatry , Volume 174 , Issue 4 , April 1999 , pp. 353 - 359
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest

Supported by a US Public Health Service research grant MH-50379.

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington. DC: APA.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle ScholarPubMed
Blake, D. D., Weathers, F. W., Nagy, L. M., et al (1995) The development of a clinician administered PTSD scale. Journal of Traumatic Stress, 8, 75–90.Google ScholarPubMed
Blanchard, E. B., Hickling, E. J., Taylor, A. E., et al (1994) Who develops PTSD from motor vehicle accidents? Behaviour Research Therapy, 34, 1–10.CrossRefGoogle Scholar
Bleich, A., Koslowsky, M., Dolev, A., et al (1997) Post-traumatic stress disorder and depression. An analysis of comorbidity. British Journal of Psychiatry, 170, 479–182.Google Scholar
Ehlers, A., Mayou, R. A. & Bryant, B. (1999) Psychological predictors of chronic PTSD after motor vehicle accident. Journal of Abnormal Psychology, in press.Google Scholar
Holen, A. (1993) The North Sea oil rig disaster. In International Handbook, of Traumatic Stress Syndromes (eds Wilson, J. P. & Raphael, B.). New York: Plenum.Google Scholar
Horowitz, M., Wilner, N. & Alvarez, W. (1979) Impact of event scale: a measure of subjective stress, Psychosomatic Medicine, 41, 3.CrossRefGoogle Scholar
Keane, T. M., Caddell, J. M. & Taylor, K. L. (1988) Mississippi scale for combat-related posttraumatic stress disorder: three studies in reliability and validity. Journal of Consulting and Clinical Psychology 56, 85–90.Google Scholar
Kessier, R. C., Sonega, A., Bromat, A., et al (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 1048–1060.CrossRefGoogle Scholar
Marmar, C. R., Weiss, D. S., Schienger, W. E., et al (1994) Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans. American Journal of Psychiatry 151, 902–907.Google ScholarPubMed
McFarlane, A. C. (1999) The phenomenology of post traumatic stress disorder following a natural disaster. Journal of Nervous and Mental Disease. 176, 22–29.Google Scholar
McFarlane, A. C. (1992) Avoidance and intrusion in posttraumatic stress disorder. Journal of Nervous and Mental Disease, 180, 439–445.Google Scholar
Perry, S., Difede, J., Muagni, G., et al (1992) Predictors of post traumatic stress disorder after burn injury. American Journal of Psychiatry 149, 931–935.Google ScholarPubMed
Shalev, A. Y., Peri, T., Canetti, L., et al (1996) Predictors of PTSD in injured trauma survivors: a prospective study. American Journal of Psychiatry, 153, 219–225.Google Scholar
Shalev, A. Y., Freedman, S., Peri, T., et al (1997) Predicting PTSD in civilian trauma survivors: prospective evaluation of self-report and clinician-administered instruments. British Journal of Psychiatry, 170, 558–564.CrossRefGoogle ScholarPubMed
Shalev, A. Y., Freedman, S., et al (1998a) Prospective study of PTSD and depression following trauma. American Journal of Psychiatry. 155, 630–637.CrossRefGoogle ScholarPubMed
Shalev, A. Y., Sahar, T., Freedman, S., et al (1988b) A prospective study of heart rate responses following trauma and the subsequent development of PTSD. Archives of General Psychiatry, 55, 553–559.CrossRefGoogle Scholar
Solomon, Z., Garb, R., Bleich, A., et al (1985) Reactivation of combat related posttraumatic stress disorder. American Journal of Psychiatry, 144, 1–55.Google Scholar
Spielberger, C. D. (1983) Manual far State Trait Anxiety Inventory Palo Alto, CA: Consulting Psychologists Press.Google Scholar
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