Posttraumatic Stress Disorder Symptoms and Social and Occupational Functioning of People With Schizophrenia

May combine two claims.

BASIS-32 subjective ratings were significantly correlated with depression and PTSD symptom severity, whereas QLS interviewer ratings were not significantly correlated with BASIS-32 ratings or with depression or PTSD severity.

“The BASIS-32 requires participants to provide subjective ratings regarding how much difficulty they experience in different life domains (e.g., household responsibilities, getting along with people, and feeling close to others), which are significantly correlated with severity of depression and PTSD symptoms. In contrast, the QLS yields objective ratings based on the interviewer's ascertainment of”

May combine two claims.

Each one-point increase in positive symptoms was associated with a 20% increase in odds of PTSD (OR=1.20), such that a five-point increase doubles the odds.

“For every point increase in positive symptoms, the risk of PTSD increased by 20% (OR=1.20, p=.001; see Table 2), so a five point increase in positive symptoms doubles the risk of PTSD.”

May combine two claims.

Interviewer-rated interpersonal and occupational functioning on the QLS and current employment status were not associated with PTSD diagnosis or symptoms.

“However, interviewer-rated interpersonal (OR=0.66, p=.22) and occupational (OR=0.97, p=.93) functioning on the QLS were not associated with PTSD diagnosis or symptoms, nor was current employment status (OR=1.10, p=.87).”

May combine two claims.

Each one-point increase in depression symptoms was associated with a 45% increase in odds of PTSD (OR=1.45), such that a five-point increase more than triples the odds.

“Moreover, for every point increase in depression symptoms, the risk of PTSD increases by 45% (OR=1.45, p<.001), so that for every five point increase in depression symptoms, the risk of PTSD is more than three times higher.”

The quote only partly states this claim.

Participants with a head injury accompanied by loss of consciousness were more likely to meet criteria for sub-threshold PTSD (OR=2.66).

“Participants with a history of head injury were more likely to meet criteria for sub-threshold PTSD (OR=2.66, p=.02).”

May combine two claims.

More severe depressive symptoms predicted PTSD diagnosis (OR=1.45) and sub-threshold PTSD (OR=1.35).

“as did depression symptoms (OR=1.45, 95% CI: 1.18-1.78, OR=1.35, 95% CI: 1.16-1.58, respectively).”

May combine two claims.

The most frequently reported traumatic events were serious injury (41%), beatings to the head (35%), lack of shelter (33%), and forced separation from family (31%).

“The most common traumatic events were serious injury (41%), beatings to the head (35%), lack of shelter (33%), and forced separation from family members (31%).”

May combine two claims.

Nine of the 20 assessed traumatic events were linked to higher risk of PTSD diagnosis, with the largest odds for combat (OR=7.11), brainwashing (OR=6.40), and murder of a family member or friend (OR=6.34).

“Of the 20 traumatic events, nine were associated with increased risk of a PTSD diagnosis, with the highest risk being conferred by experiencing combat (OR=7.11, p=.002), brainwashing (OR=6.40, p=.003), and the murder of a family member or a friend (OR=6.34, p=.02) (see Table 3).”

May combine two claims.

In multiple regression, interviewer-rated interpersonal functioning was positively predicted by female gender and negatively predicted by age at onset of psychosis and positive and negative symptoms.

“Interviewer-rated interpersonal functioning was positively predicted by female gender (B=.39, p=.03), and was negatively predicted by age at onset of psychosis symptoms (B=−.05, p<.001) and positive (B=−.04, p=.007) and negative (B=−.05, p=.004) symptoms.”

May combine two claims.

Higher patient-rated interpersonal and occupational functioning on the BASIS-32 were each associated with lower odds of PTSD diagnosis.

“Results indicated that patients who rated themselves higher in interpersonal (OR=0.22, p<.001) and occupational functioning (OR=0.26, p=.001) on the BASIS-32 were less likely to have PTSD (see Table 2 and Table 4).”

May combine two claims.

A greater number of reported traumatic events was associated with higher PTSD symptom severity (r=.52) and increased odds of PTSD diagnosis (OR=1.16).

“There was a positive relationship between the number of traumatic events reported and PTSD symptoms (r=.52, p<.001) and PTSD diagnosis (OR=1.16, p=.006).”

May combine two claims.

Rape or sexual abuse did not predict PTSD diagnosis but was associated with increased risk of sub-threshold PTSD (OR=3.21).

“Rape/sexual abuse was not predictive of PTSD diagnosis (OR=0.90, p=.88), but did predict increased risk for sub-threshold PTSD (OR=3.21, p=.01).”

May combine two claims.

More severe positive symptoms predicted PTSD diagnosis (OR=1.20) and sub-threshold PTSD (OR=1.13).

“Positive symptoms predicted PTSD (OR=1.20, 95% CI: 1.08-1.33) and sub-threshold PTSD diagnoses (OR=1.13, 95% CI: 1.05-1.22)”

May combine two claims.

More severe PTSD symptoms were correlated with more severe positive symptoms (r=.32) and depression (r=.43).

“Patients with more PTSD symptoms also reported more positive symptoms (r=.32, p<.001) and depression (r=.43, p<.001).”

May combine two claims.

In this sample of 125 outpatients with schizophrenia, 76% reported at least one PTSD symptom, 12% met DSM-IV criteria for current PTSD, and 26% met criteria for at least sub-threshold PTSD.

“PTSD symptoms were present in 76% of participants, with 12% of participants meeting diagnostic criteria for PTSD.”

• Also stated in: § Clinical characteristics · plain

  “Most (82%) participants reported experiencing at least one traumatic event, and 76% reported PTSD symptoms, with 12% of participants meeting DSM-IV diagnostic criteria for PTSD and 26% meeting criteria for at least sub-threshold PTSD (see Table 1).”

• Also stated in: § Discussion · plain

  “Additionally, 76% of participants reported at least one PTSD symptom, one in four participants had sub-threshold PTSD (meaning they met three of the four criteria DSM-IV criteria for PTSD), and 12% met full criteria for current PTSD.”

May combine two claims.

PTSD symptom severity did not predict interviewer-rated interpersonal (B=.21) or occupational (B=.09) functioning or employment status (OR=0.98) in the multiple regressions.

“but were not predictive of interviewer-rated interpersonal (B=.21, p=.16) or occupational (B=.09, p=.68) functioning, or of employment status (OR=0.98, p=.96).”

May combine two claims.

All participants with PTSD met criteria for depression, and 15% of those with depression also met criteria for PTSD.

“There was very high comorbidity between depression and PTSD diagnoses, with all participants with PTSD meeting criteria for depression, and 15% of those meeting criteria for depression also meeting criteria for PTSD.”

May combine two claims.

Participants with PTSD had higher rates of depression and more severe positive symptoms than those without PTSD.

“Participants with PTSD had higher rates of depression and more severe positive symptoms.”

• Also stated in: § Discussion · plain

  “participants with PTSD reported higher rates of depression (72%) and PTSD also had more severe psychosis symptoms than those without PTSD.”

May combine two claims.

Interviewer-rated interpersonal functioning was positively associated with female gender and negatively associated with age, age at onset of psychosis, positive symptom severity, negative symptom severity, and depression severity.

“In addition, interviewer-rated interpersonal functioning was positively associated with the participant being female and negatively associated with participant age, age at onset of psychosis, positive and negative symptom severity, and depression severity.”

May combine two claims. The quote only partly states this claim.

82% of participants reported at least one traumatic event, and they experienced an average of 4.60 of the 20 assessed events.

“Most (82%) participants reported experiencing at least one traumatic event”

• Also stated in: § Traumatic events · plain

  “who indicated experiencing an average of 4.60 (SD=4.75) of the 20 assessed events.”

• Also stated in: § Discussion · plain

  “The great majority of participants (82%) reported experiencing traumatic events”

May combine two claims.

Each one-point improvement in patient-rated interpersonal functioning was associated with more than five times lower odds of PTSD (OR=5.17), and each one-point improvement in occupational functioning with more than four times lower odds (OR=4.22).

“Indeed, for every point improvement in interpersonal functioning, patient risk of PTSD decreased more than 5 times (OR=5.17, p<.001), and for every point improvement in occupational functioning, patient risk of PTSD decreased more than 4 times (OR=4.22, p=.001).”

May combine two claims.

Negative symptoms were the only significant predictor of interviewer-rated occupational functioning (B=-.11) and the only unique predictor of current employment (OR=0.84).

“Negative symptoms were the only significant predictor of interviewer-rated occupational functioning (B=−.11, p<.001). Multiple logistic regression found that negative symptoms were also the only unique predictor of current employment status (OR=0.84, p=.01).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims. The quote only partly states this claim.

The BASIS-32 Relation to Self and Others and Daily Living/Role Functioning subscales had good internal reliability (α=.81 and α=.79, respectively).

“The internal reliability of the Relation to Self and Others scale was good (α=.81).”

• Also stated in: § Measures · plain

  “The internal reliability of the Daily Living/Role Functioning Scale was good (α=.79).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Multiple imputation using 20 datasets was used to account for missing data; 70.4% had complete data and FSIQ had the most missing (12 participants).

“Multiple imputation using 20 imputed datasets was used to account for missing data. Most of the participants (70.4%) had complete data, and the variable with the most missing data was Full Scale IQ, which was missing for 12 participants.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Raters received standard PANSS training with required inter-rater reliability of r=0.80, and the QLS required inter-rater reliability was r=.80.

“All raters received the standard training for administering the PANSS with a required inter-rater reliability of r=0.80.”

• Also stated in: § Measures · plain

  “The required inter-rater reliability for the QLS was r=.80.”

Classified as probably not a substantial claim. May combine two claims.

Schizophrenia diagnosis was confirmed by chart review and the SCID conducted by a psychiatrist or psychiatric nurse.

“Schizophrenia diagnosis was confirmed by chart review and the Structured Clinical Interview for DSM-IV (SCID)(Spitzer et al, 1992) conducted by a psychiatrist or psychiatric nurse.”

• cites Spitzer et al, 1992Not checked yet

  Not checked in the free run.

May combine two claims.

There was no evidence of multicollinearity among predictors (mean VIF=1.62, highest=2.40) and no violations of least-squares assumptions in residual plots.

“Results of the multicollinearity analysis found no evidence of collinearity between predictors, as the highest correlation was r=−.59 between education and FSIQ, and the mean VIF was 1.62, with the highest VIF being 2.40. No violations of least-squares assumptions were found in the plots of residuals against fitted values.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

This was a secondary data analysis, so the data were not collected to answer this exact question and other unmeasured variables may confound the results.

“Finally, this is a secondary data analysis and therefore the data was not collected to answer this exact question, and other unmeasured variables may be confounding the results.”

May combine two claims.

The sample was primarily male and almost exclusively white or black, so results may not generalize to women or patients of other racial or ethnic backgrounds.

“The sample was also primarily male and almost exclusively participants who identified as white or black, and thus results may not be as generalizable to women or patients with other racial or ethnic backgrounds.”

Classified as probably not a substantial claim. May combine two claims.

Reducing PTSD symptoms in patients with schizophrenia could improve their subjective sense of interpersonal and occupational competency and increase self-efficacy for achieving personal goals.

“Since the self-appraisal of one's own functioning may be an important factor contributing to quality of life and goal setting, reducing PTSD symptoms in patients with schizophrenia could improve their subjective sense of interpersonal and occupational competency, and could increase self-efficacy for achieving important personal goals.”

Probably not a substantial claim: may not pass S2 (checkable).

Understanding the unique contributions of PTSD, depression, and psychosis to functioning could have implications for clinical care and for identifying patients who may be having more difficulty.

“Since PTSD, depression, and psychosis can all compromise functioning, understanding their unique contributions to functioning could have implications for clinical care and the identification of patients who may be having more difficulty.”

May combine two claims.

Evidence-based interventions for PTSD in patients with psychosis have demonstrated significant improvements in PTSD symptoms, general mental health and depression symptoms, and self-reported interpersonal functioning.

“evidence-based interventions for PTSD in patients with psychosis have demonstrated significant improvements in PTSD symptoms(de Bont et al, 2013; Frueh et al, 2009b; Mueser et al, 2008; van den Berg et al, 2015a), general mental health and depression symptoms(Frueh et al, 2009b; Mueser et al, 2008; Trappler et al, 2007), and self-reported functional improvements in interpersonal relationships(Frue”

• cites de Bont et al, 2013Not checked yet

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• cites Frueh et al, 2009bNot checked yet

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• cites Mueser et al, 2008Not checked yet

  Not checked in the free run.

May combine two claims.

The 82% traumatic event exposure rate is similar to rates in other studies of people with SMI and much higher than rates reported by the general public.

“The great majority of participants (82%) reported experiencing traumatic events, which is similar to the rates of traumatic events reported in other studies of people with SMI, and much higher than rates reported by the general public(Kessler et al, 1995).”

• cites Kessler et al, 1995Not checked yet

  Not checked in the free run.

May combine two claims.

Because PTSD symptoms are associated with more severe positive psychosis symptoms, neglecting PTSD may hinder recovery from both trauma and psychosis, possibly leading to higher antipsychotic doses and impaired recovery.

“Moreover, given the association between PTSD symptoms and the severity of positive psychosis symptoms, neglect of PTSD symptoms may not only hinder recovery from trauma, but also from psychosis, perhaps resulting in use of higher doses of antipsychotic medication and impaired recovery.”

May combine two claims.

Psychosis, depression, and PTSD are highly comorbid, and current diagnostic and treatment approaches often do not account for multiple overlapping comorbidities, which may negatively impact functioning additively or multiplicatively.

“Indeed psychosis, depression, and PTSD are all highly comorbid and our current diagnostic and treatment approaches often do not account for multiple overlapping comorbidities which may negatively impact functioning in both additive and multiplicative ways.”

May combine two claims.

Attention to trauma history and PTSD symptoms in patients with schizophrenia is critical because PTSD symptoms cause distress and may play a role in subjective interpersonal and occupational functioning.

“Attention to trauma history and PTSD symptoms of patients with schizophrenia is critical, not only because of the distress conferred by PTSD symptoms, but also because it may play a role in subjective interpersonal and occupational functioning.”

May combine two claims.

Studies have found that despite severe trauma histories and high PTSD rates, few patients receiving SMI services had a PTSD diagnosis in their medical charts and clinicians were often unaware of their trauma histories.

“Indeed studies have found that despite severe trauma histories and high rates of PTSD, few patients receiving clinical services for SMI had a PTSD diagnosis in their medical charts and clinicians were often unaware of their trauma histories(Cascardi et al, 1996; Craine et al, 1988; Cusack et al, 2006; Lommen et al, 2009; Mueser et al, 1998).”

• cites Cascardi et al, 1996Not checked yet

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• cites Craine et al, 1988Not checked yet

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• cites Cusack et al, 2006Not checked yet

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