The phenomenology of posttraumatic stress disorders following a natural disaster.
This study examined the utility of the DSM-III diagnostic criteria for posttraumatic stress disorder (PTSD) in a high-risk group of 50 firefighters who had had an intense exposure to a natural disaster 8 months before being interviewed. Follow-up over the next 3 years allowed examination of the ability of these diagnostic criteria to predict a pattern of chronic posttraumatic morbidity. They predicted a pattern of chronic disorder, demonstrated by the finding that eight of the 15 subjects who had definite or borderline PTSD at 8 months remained symptomatic 3 years later. A disturbance of attention and concentration appeared to be the best predictor of chronic PTSD. The longitudinal course of posttraumatic morbidity in these 50 firefighters was compared with a matched group of 96 uninterviewed subjects 11 and 29 months after the disaster. Although the interview provoked an emotional catharsis in a number of firefighters, the long-term morbidity in the two groups was comparable. Fourteen subjects who did not have PTSD continued to experience intense imagery 8 months after the disaster. This observation raises questions about whether such thoughts and feelings have adequate specificity as diagnostic criteria for PTSD in a group that has recently been exposed to a traumatic event.
McFarlane
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AC
Department of Psychiatry, Flinders Medical Centre, Bedford Park, Australia.
D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D001288:Attention; D002399:Catharsis; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology; D005390:Fires; D006801:Humans; D007092:Imagination; D008016:Life Change Events; D008137:Longitudinal Studies; D008370:Manuals as Topic / Q000592:standards; D008568:Memory; D009784:Occupational Diseases / Q000523:psychology; D011336:Probability; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology