Cited by 120Posttraumatic Stress Disorder ResearchTraumatic Brain Injury ResearchChild Abuse and Trauma

Subthreshold posttraumatic stress disorder: A meta-analytic review of DSM–IV prevalence and a proposed DSM–5 approach to measurement.

Brancu, Mira, Mann-Wrobel, Monica, Beckham, Jean C., Wagner, H. Ryan, Elliott, Alyssa, Robbins, Allison T., Wong, Madrianne, Berchuck, Ania E. +1 more·2016·Psychological Trauma: Theory, Research, Practice, and Policy

Abstract

Subthreshold posttraumatic stress disorder (PTSD) is a chronic condition that is often ignored, the cumulative effects of which can negatively impact an individual's quality of life and overall health care costs. However, subthreshold PTSD prevalence rates and impairment remain unclear due to variations in research methodology. This study examined the existing literature in order to recommend approaches to standardize subthreshold PTSD assessment. We conducted (a) a meta-analysis of subthreshold PTSD prevalence rates and (b) compared functional impairment associated with the 3 most commonly studied subthreshold PTSD definitions. Meta-analytic results revealed that the average prevalence rate of subthreshold PTSD across studies was 14.7%, with a lower rate (12.6%) among the most methodologically rigorous studies and higher rate (15.6%) across less rigorous studies. There were significant methodological differences among reviewed studies with regard to definition, measurement, and population. Different definitions led to prevalence rates ranging between 13.7% and 16.4%. Variability in prevalence rates most related to population and sample composition, with trauma type and community (vs. epidemiological) samples significantly impacting heterogeneity. Qualitative information gathered from studies presenting functional correlates supported current evidence that psychological and behavioral parameters were worse among subthreshold PTSD groups compared with no-PTSD groups, but not as severe as impairment in PTSD groups. Several studies also reported significant increased risk of suicidality and hopelessness as well as higher health care utilization rates among those with subthreshold PTSD (compared with trauma exposed no-PTSD samples). Based on findings, we propose recommendations for developing a standard approach to evaluation of subthreshold PTSD.

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Crossref · 10.1037/tra0000078

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Authors
Brancu, M., Mann-Wrobel, M., Beckham, J. C., Wagner, H. R., Elliott, A., Robbins, A. T., Wong, M., Berchuck, A. E., & Runnals, J. J.
Affiliations
Duke Medical Center (US)
Venue
Psychological Trauma: Theory, Research, Practice, and Policy
Published
2016-03
Volume
8
Issue
2
Pages
222-232
ISSN
  • 1942-9681 (ISSN-L)
  • 1942-969X
OpenAlex
W2414738194
Cited by
120
References
95
Citations by year
2026: 10 · 2025: 10 · 2024: 8 · 2023: 11 · 2022: 14 · 2021: 15 · 2020: 14 · 2019: 9 · 2018: 15 · 2017: 10 · 2016: 3 · 2015: 1
FWCI
11.99
Type
journal article
Language
en
Open access
closed
Locations
  • Psychological Trauma Theory Research Practice and Policy (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords
PTSD prevalence, DSM-IV, DSM-5, functional disability, measurement standardization, suicidality, hopelessness, health care utilization, trauma exposure
MeSH terms
Humans, Stress Disorders, Post-Traumatic, Prevalence, Diagnostic and Statistical Manual of Mental Disorders

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