Psychopathology following trauma: the role of subjective experience.
BACKGROUND
The DSM-IV definition of posttraumatic stress disorder (PTSD) widened the stressor criterion to include objective (A1) and subjective (A2) components. The prevalence of Criterion A2, and its association with traumatic memory and psychopathology, was examined in a large community sample.


METHODS
The presence of Criterion A2 and traumatic memories, as well as DSM-IV anxiety, affective and substance use disorders, were examined in a community sample of 6104 adults with a history of traumatic exposure.


RESULTS
Most individuals met Criterion A2 (76%), with higher prevalence in females (81%) than males (69%). A2 was more common following certain traumas (such as assaultive violence). Excluding those people with PTSD, prevalence of most psychiatric disorders was higher in those who met Criterion A2 than in those who only met Criterion A1. Only 3% of those who did not meet A2 went on to suffer persistent traumatic memories. The prevalence of psychiatric disorders was higher in those with A2 and traumatic memories than in those with A2 and no traumatic memories.


CONCLUSIONS
The retrospective nature of the data raises the potential for reporting biases. The data set allowed only one of several possible predictors of posttraumatic adjustment to be examined and only 12-month, and not lifetime, prevalence of psychiatric conditions was available.


CONCLUSIONS
The experience of powerful emotions at the time of traumatic exposure is common and is associated with increased prevalence not only of PTSD, but also of a range of other psychiatric conditions. Traumatic memories may mediate this association.
Creamer
Mark
M
Australian Centre for Posttraumatic Mental Health, University of Melbourne, A&RMC Repat Campus, P.O. Box 5444, West Heidelberg, Victoria 3081, Australia. markcc@unimelb.edu.au
McFarlane
Alexander C
AC
Burgess
Philip
P
D000328:Adult; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D019548:Crime Victims / Q000523:psychology; D003625:Data Collection; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008297:Male; D008568:Memory; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D014754:Violence / Q000523:psychology