What parts of PTSD are normal: intrusion, avoidance, or arousal? Data from the Northridge, California, earthquake.
The incidence and comorbidity of posttraumatic stress disorder (PTSD) are addressed in a study of 130 Northridge, California, earthquake survivors interviewed 3 months post-disaster. Only 13% of the sample met full PTSD criteria, but 48% met both the re-experiencing and the arousal symptom criteria, without meeting the avoidance and numbing symptom criterion. Psychiatric comorbidity was associated mostly with avoidance and numbing symptoms. For moderately severe traumatic events, re-experiencing and arousal symptoms may be the most "normal," and survivors with a history of psychiatric problems may be those most likely to develop full PTSD. A system that considers people who meet all three symptom criteria to have a psychiatric disorder yet recognizes the distress of other symptomatic survivors may best serve traumatized populations.
McMillen
J C
JC
Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University, St. Louis, Missouri 63130, USA.
North
C S
CS
Smith
E M
EM
D000328:Adult; D000368:Aged; D001143:Arousal; D001288:Attention; D001362:Avoidance Learning; D015897:Comorbidity; D004190:Disasters; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D012016:Reference Values; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology; D017741:Survivors / Q000523:psychology