Anger and posttraumatic stress disorder symptoms in crime victims: A longitudinal analysis.

Among trauma-exposed individuals, severity of posttraumatic stress disorder (PTSD) symptoms is strongly correlated with anger. The authors used 2 longitudinal data sets with 282 and 218 crime victims, respectively, to investigate the temporal sequence of anger and PTSD symptoms following the assault. Cross-lagged regression analyses indicated that PTSD symptoms predicted subsequent level of anger, but that anger did not predict subsequent PTSD symptoms. Testing alternative models (common factor model, unmeasured 3rd variable model) that might account for spuriousness of the relation strengthened confidence in the results of the cross-lagged analyses. Further analyses suggested that rumination mediates the effect of PTSD symptoms on anger. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screening for posttraumatic stress disorder in a general psychiatric outpatient setting.

Posttraumatic stress disorder (PTSD) may affect survivors of a number of accidents and illnesses, in addition to violence victims and combat veterans. Prior research suggests that PTSD may be underdiagnosed when trauma is not the presenting problem. Thus, a PTSD screening scale might have utility in routine clinical settings. The authors evaluated the screening performance of the Posttraumatic Diagnostic Scale (PDS) in a general psychiatric setting. Results indicated that the PDS performed as well in this setting as it did in the original trauma-focused validation studies, independent of PTSD status as a primary, versus secondary, reason for presenting. A simple cutoff score was adequate for case identification. There were no gender effects, and the scale performed equally well among patients with, versus without, a depressive diagnosis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Causal attributions in posttraumatic stress disorder: Implications for clinical research and practice.

In this paper we seek to illuminate connections among basic research findings in cognition and causal inference, clinical research on the treatment of Posttraumatic Stress Disorder (PTSD), and the practices of clinicians who work with trauma survivors. We examine one particular (and, we believe, important) aspect of PTSD: The creation and maintenance of causal attributions about trauma. We suggest that elements of two principal theories of causal induction (the connectionist model and the "Power PC" causal power model) clarify the role of causal attributions in creating and sustaining the symptoms of PTSD. By exploring the role of causal attributions in creating and sustaining posttraumatic symptoms, we hope to understand better the subjective experience of trauma and its sequelae. We then suggest new directions for clinical research on cognitive restructuring in PTSD patients as well as ideas for optimizing attribution-based therapies for trauma survivors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing posttraumatic stress disorder with or without reference to a single, worst traumatic event: Examining differences in factor structure.

The authors examined the effects of a methodological manipulation on the Posttraumatic Stress Disorder (PTSD) Checklist’s factor structure: specifically, whether respondents were instructed to reference a single worst traumatic event when rating PTSD symptoms. Nonclinical, trauma-exposed participants were randomly assigned to 1 of 2 PTSD assessment conditions: referencing PTSD symptoms to their worst trauma (trauma-specific group, n = 218) or to their overall trauma history in general (trauma-general group, n = 234). A 3rd group of non-trauma-exposed participants (n = 464) rated PTSD symptoms globally from any stressful event. Using confirmatory factor analysis, the authors show that the 4-factor PTSD model proposed by D. W. King, G. A. Leskin, L. A. King, and F. W. Weathers (1998; separating effortful avoidance and emotional numbing) demonstrated the best model fit for trauma-general and non-trauma-exposed participants. The 4-factor PTSD model proposed by L. J. Simms, D. Watson, and B. N. Doebbeling (2002; emphasizing a general dysphoria factor) demonstrated the best model fit for trauma-specific participants. Measurement invariance testing revealed that non-trauma-exposed participants were different from both trauma-exposed groups on factor structure parameters, but trauma groups were not substantially different from each other. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential item functioning in a Spanish translation of the PTSD Checklist: Detection and evaluation of impact.

This study demonstrated the application of an innovative item response theory (IRT) based approach to evaluating measurement equivalence, comparing a newly developed Spanish version of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) with the established English version. Basic principles and practical issues faced in the application of IRT methods for instrument evaluation are discussed. Data were derived from a study of the mental health consequences of community violence in both Spanish speakers (n = 102) and English speakers (n = 284). Results of differential item functioning (DIF) analyses revealed that the 2 versions were not fully equivalent on an item-by-item basis in that 6 of the 17 items displayed uniform DIF. No bias was observed, however, at the level of the composite PCL-C scale score, indicating that the 2 language versions can be combined for scale-level analyses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)