Predictors of chronic post-traumatic stress disorder: A prospective study
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.
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Prospective studies disagree about whether peritraumatic dissociation predicts later PTSD.
“Indeed, some prospective studies suggest that peritraumatic dissociation predicts PTSD over time (e.g., Birmes et al., 2003; Ehlers, Mayou, & Bryant, 1998; Holen, 1991; Marmar et al., 1999; Murray, Ehlers, & Mayou, 2002; Schafer, Barkmann, Riedesser, & Schulte-Markwort, 2004; Shalev & Freedman, 2005; Ursano et al., 1999); however, others do not”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Freedman et al., 1999
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- Authors
- Freedman, S. A., Brandes, D., Peri, T., & Shalev, A. Y.
- Affiliations
- Hadassah Medical Center (IL)
- Corresponding author
- Shalev, Arieh Y.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 1999-04
- Volume
- 174
- Issue
- 4
- Pages
- 353-359
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2112581545
- Cited by
- 186
- References
- 3
- Citations by year
- 2023: 3 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 6 · 2018: 3 · 2017: 5 · 2016: 7 · 2015: 9 · 2014: 3 · 2013: 5 · 2012: 5
- FWCI
- 13.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH-50379, R01MH050379)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- chronic posttraumatic stress disorder, predictors of PTSD, depressive symptoms, intrusion symptoms, trauma survivors, emergency department patients
- MeSH terms
- Adult, False Positive Reactions, Female, Forecasting, Humans, Life Change Events, Male, Predictive Value of Tests, Prognosis, Prospective Studies, ROC Curve, Stress Disorders, Post-Traumatic, Prevalence
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