The nature and course of subthreshold PTSD.
ABSTRACT This study investigated rates of subthreshold PTSD and associated impairment in comparison to no PTSD and full PTSD and prospectively followed the course of subthreshold symptoms over 3 years. 3360 workers dispatched to the WTC site following 9/11 completed clinician interviews and self-report measures at three time points each one year apart. At Time 1, 9.7% of individuals met criteria for subthreshold PTSD. The no PTSD, subthreshold PTSD, and full PTSD groups exhibited significantly different levels of impairment, rates of current MDD diagnosis, and self-reported symptoms of depression. At Time 2, 29% of the initial sample with subthreshold PTSD continued to meet criteria for subthreshold or full PTSD; at Time 3, this was true for 24.5% of the initial sample. The study lends credence to the clinical significance of subthreshold PTSD and emphasizes that associated impairment may be significant and longstanding. It also confirms clinical differences between subthreshold and full PTSD.
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ABSTRACT: A 15-year phenomenological case study of an exceptional female from age 15 through 30 was focused on exploring the subjective experience of development during adolescence and young adulthood, with attention to how giftedness and context interacted. The main focus became her response to trauma, which was revealed early in the study. Data, including recollected childhood experiences, were gathered through letters, e-mail, face-to-face interaction, and journals and essays from her troubled adolescence. The central phenomenon that emerged is given particular attention: that giftedness was both an asset and a vulnerability throughout these years, certainly as she struggled in the aftermath of trauma and developed strategies for surviving and healing. The struggles of the subject included dealing with posttraumatic stress disorder (PTSD). The concepts of overexcitability and positive disintegration are used to frame some findings.Roeper Review 10/2012; 34(4):244-260. DOI:10.1080/02783193.2012.715336
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ABSTRACT: BACKGROUND: Although only a few people exposed to a traumatic event (TE) develop posttraumatic stress disorder (PTSD), symptoms that do not meet full PTSD criteria are common and often clinically significant. Individuals with these symptoms sometimes have been characterized as having subthreshold PTSD, but no consensus exists on the optimal definition of this term. Data from a large cross-national epidemiologic survey are used in this study to provide a principled basis for such a definition. METHODS: The World Health Organization World Mental Health Surveys administered fully structured psychiatric diagnostic interviews to community samples in 13 countries containing assessments of PTSD associated with randomly selected TEs. Focusing on the 23,936 respondents reporting lifetime TE exposure, associations of approximated DSM-5 PTSD symptom profiles with six outcomes (distress-impairment, suicidality, comorbid feardistress disorders, PTSD symptom duration) were examined to investigate implications of different subthreshold definitions. RESULTS: Although consistently highest outcomes for distress-impairment, suicidality, comorbidity, and PTSD symptom duration were observed among the 3.0% of respondents with DSM-5 PTSD rather than other symptom profiles, the additional 3.6% of respondents meeting two or three of DSM-5 criteria B-E also had significantly elevated scores for most outcomes. The proportion of cases with threshold versus subthreshold PTSD varied depending on TE type, with threshold PTSD more common following interpersonal violence and subthreshold PTSD more common following events happening to loved ones. CONCLUSIONS: Subthreshold DSM-5 PTSD is most usefully defined as meeting two or three of DSM-5 criteria B-E. Use of a consistent definition is critical to advance understanding of the prevalence, predictors, and clinical significance of subthreshold PTSD.Biological Psychiatry 04/2014; 77(4). DOI:10.1016/j.biopsych.2014.03.028 · 9.47 Impact Factor
- Child and Youth Care Forum 01/2015; DOI:10.1007/s10566-015-9299-9 · 1.25 Impact Factor