Article

Duration of Exposure and the Dose-Response Model of PTSD

University of Washington Medical School, Department of Psychiatry and Behavioral Sciences, Box 356560, Seattle,WA 98195-0650, USA.
Journal of Interpersonal Violence (Impact Factor: 1.64). 03/2009; 25(1):63-74. DOI: 10.1177/0886260508329131
Source: PubMed

ABSTRACT

A dose-response model underlies posttraumatic stress disorder (PTSD) and posits a relationship between event magnitude and clinical outcome. The present study examines whether one index of event magnitude--duration of exposure--contributes to risk of PTSD among female victims of sexual assault. Findings support a small but significant contribution of event duration to clinical status in the immediate aftermath of trauma but not at 3-month follow-up. The opposite pattern is obtained for subjective appraisals of threat. These findings add to a growing literature that suggests that a simple application of the dose-response model to objective event characteristics may be insufficient to explain the risk of PTSD.

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    • "Many investigators (Groleau et al., 2013; Kaysen et al., 2010; Martin et al., 2013; Ozer et al., 2008) point out that peritraumatic reactions, including the meaning attached to the sexualized assault, are highly predictive of later difficulties and may modify the impact of other variables such as the number of trauma exposures. For example, for victims of sexualized assault, subjective appraisal of threat is more significant in predicting risk of PTSD than the duration of the assault (Kaysen et al., 2010). The centrality of a traumatic event, i.e. the extent to which the event becomes part of the person's sense of identity or life story, and level of threat to core beliefs, i.e. the extent to which the event violates basic assumptions about the world, both predict both posttraumatic distress and posttraumatic growth (Groleau et al., 2013). "
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    • "For example, the unexpected death of a close friend or relative was endorsed by 75% of our sample; life-threatening illness was endorsed by 54% of our sample; and exposure to a natural disaster was endorsed by 79% of our Bay Area sample, many of whom may have been exposed to the 1989 Bay Area earthquake. We also did not collect information on either age at trauma exposure, number of exposures to each specific type of trauma or severity of traumatic events, each of which is likely to play an important role in the relationship between trauma exposure and inflammation (Danese et al., 2007; Kaysen et al., 2010). "
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    • "Cumulative trauma burden, intense adversities, and polyvictimization across life span have been found to contribute to significant unique variance in mental health outcomes beyond that accounted for by the combination of all aggregate trauma and victimization types (e.g., Kira et al., 2008a; Richmond, Elliott, Pierce, Aspelmeier, & Alexander, 2009). The dose-dependent response model has proved to be insufficient in explaining the risk for PTSD symptoms in such CT situations (e.g., Kaysan et al., 2010). "
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