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Cited by 217Posttraumatic Stress Disorder ResearchChild Abuse and TraumaTraumatic Brain Injury Research

Early predictors of chronic post-traumatic stress disorder in assault survivors

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KLEIM, BIRGIT, EHLERS, ANKE, GLUCKSMAN, EDWARD·2007·Psychological Medicine
DOI 10.1017/s0033291707001006PMC PMC2829994
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Abstract

Background: Some studies suggest that early psychological treatment is effective in preventing chronic post-traumatic stress disorder (PTSD), but it is as yet unclear how best to identify trauma survivors who need such intervention. This prospective longitudinal study investigated the prognostic validity of acute stress disorder (ASD), of variables derived from a meta-analysis of risk factors for PTSD, and of candidate cognitive and biological variables in predicting chronic PTSD following assault. Method: Assault survivors who had been treated for their injuries at a metropolitan Accident and Emergency (A&E) Department were assessed with structured clinical interviews to establish diagnoses of ASD at 2 weeks (n=222) and PTSD at 6 months (n=205) after the assault. Candidate predictors were assessed at 2 weeks. Results: Most predictors significantly predicted PTSD status at follow-up. Multivariate logistic regressions showed that a set of four theory-derived cognitive variables predicted PTSD best (Nagelkerke R2=0·50), followed by the variables from the meta-analysis (Nagelkerke R2=0·37) and ASD (Nagelkerke R2=0·25). When all predictors were considered simultaneously, mental defeat, rumination and prior problems with anxiety or depression were chosen as the best combination of predictors (Nagelkerke R2=0·47). Conclusion: Questionnaires measuring mental defeat, rumination and pre-trauma psychological problems may help to identify assault survivors at risk of chronic PTSD.

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  • Empirical studies confirm that flashbacks appear to be a specific indicator of PTSD, and the sense of 'nowness' is predictive of the course of the disorder over and above the effects of initial symptom levels.

    “Importantly, empirical studies confirm that flashbacks appear to be a specific indicator of PTSD (Bryant, et al., 2011), and the sense of 'nowness' is predictive of the course of the disorder over and above the effects of initial symptom levels (Kleim, Ehlers, & Glucksman, 2007; Michael, Ehlers, Halligan, & Clark, 2005).”

    From Episodic memory, perceptual memory, and their interaction: Foundations for a theory of posttraumatic stress disorder. (2014) · cites this paper as Kleim, Ehlers, & Glucksman, 2007

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Authors
KLEIM, B., EHLERS, A., & GLUCKSMAN, E.
Affiliations
  • King's College London (GB)
  • King's College Hospital (GB)
Corresponding author
EHLERS, ANKE
ORCID
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2007-06-22
Volume
37
Issue
10
Pages
1457-1467
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291707001006
PMC
PMC2829994
OpenAlex
W1993654480
Cited by
217
References
11
Citations by year
2026: 4 · 2025: 5 · 2024: 12 · 2023: 8 · 2022: 13 · 2021: 14 · 2020: 9 · 2019: 15 · 2018: 17 · 2017: 10 · 2016: 10 · 2015: 22 · 2014: 5 · 2013: 14 · 2012: 21
FWCI
8.01
Type
journal article
Language
en
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc-sa)
  • Research Portal (King's College London) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by-nc-sa)
  • Zurich Open Repository and Archive (University of Zurich)
Funders
  • Wellcome Trust (069777)
  • Psychiatry Research Trust
  • King's College London
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Keywords
chronic posttraumatic stress disorder, acute stress disorder, mental defeat, rumination, cognitive predictors, biological predictors, early psychological intervention, emergency department
MeSH terms
Adult, Chronic Disease, Demography, Emergency Medical Services, Female, Follow-Up Studies, Humans, Male, Predictive Value of Tests, Prospective Studies, Psychological Tests, Surveys and Questionnaires, Severity of Illness Index, Stress Disorders, Post-Traumatic, Violence, Wounds and Injuries, Survivors

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