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Analysis of the longitudinal course of PTSD in 716 survivors of 10 disasters

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Abstract

Purpose

Identification of consistent predictors of the temporal course of PTSD has been hampered by non-uniform definitions of onset and remission. Onset and remission of PTSD based on different definitions were examined in a large database of systematically assessed disaster survivors.

Methods

Directly exposed survivors of 10 disasters were studied within approximately 3 months of the disasters and again 1–3 years later, using consistent methods including full diagnostic assessment, allowing aggregation of data from different disasters into a unified database of 716 survivors.

Results

Application of existing definitions of PTSD onset and remission uncovered problems with definitions based on diagnostic threshold as well as onset/remission of symptoms. Few predictors of timing of onset and PTSD remission were identified. Regardless, PTSD symptom group C was found to be pivotal to processes involved in both onset and remission of the disorder.

Conclusions

Research findings related to the onset and remission of PTSD are highly dependent on the definition used. Both symptom-based and diagnostic threshold-based definitions are problematic. Definitions of the onset and remission of PTSD might be more effectively based on the onset and remission of group C symptoms.

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Acknowledgments

This research was supported by National Institute of Mental Health Grant MH40025 to Dr. North.

Conflict of interest

Dr. North acknowledges employment at VA North Texas Health Care System. Points of view in this document are those of the author(s) and do not necessarily represent the official position of the Department of Veterans Affairs or the United States Government. Dr. North also discloses research support from NIAAA, NIDDK, the Department of Veterans Affairs, the American Psychiatric Association, and the Orthopaedic Trauma Association, and consultant fees from the University of Oklahoma Health Sciences Center and from the Tarrant County, TX Department of Health. Ms. Oliver reports no disclosures.

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Authors and Affiliations

  1. The VA North Texas Health Care System, Dallas, TX, USA

    Carol S. North

  2. Departments of Psychiatry and Surgery/Division of Emergency Medicine, The University of Texas Southwestern Medical Center, 6363 Forest Park Rd., Dallas, TX, 75390-8828, USA

    Carol S. North

  3. The University of Texas at Dallas, Richardson, TX, USA

    Julianne Oliver

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  1. Carol S. North
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Correspondence to Carol S. North.

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North, C.S., Oliver, J. Analysis of the longitudinal course of PTSD in 716 survivors of 10 disasters. Soc Psychiatry Psychiatr Epidemiol 48, 1189–1197 (2013). https://doi.org/10.1007/s00127-012-0639-x

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  • DOI: https://doi.org/10.1007/s00127-012-0639-x

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