title: The effect of trauma onset and frequency on PTSD-associated symptoms.
abstract: BACKGROUND
  Different trauma characteristics have been suggested to lead to distinct symptom profiles. This study investigates the effect of two trauma characteristics, age of onset and frequency, on PTSD symptom profiles.
  
  
  METHODS
  Trauma characteristics (childhood versus adulthood trauma and single versus multiple trauma), psychiatric diagnosis, PTSD severity, depressive symptoms, dissociation, guilt, shame, anger, and interpersonal sensitivity were assessed in 110 PTSD outpatients.
  
  
  RESULTS
  Single versus multiple trauma and childhood versus adulthood trauma groups did not differ in depressive symptom and co-morbidity. Multiple trauma patients reported more dissociation, guilt, shame, and interpersonal sensitivity than those that experienced single trauma. Anger of multiple trauma patients was more often directed towards themselves, whereas anger in single trauma patients was more often directed towards others. Childhood trauma patients reported more dissociation and state anger than adulthood trauma patients. However, with the exception of multiple trauma patients having more dissociation and shame than those with single trauma, all differences disappeared after controlling for PTSD severity.
  
  
  CONCLUSIONS
  This study is a first step in unraveling the impact of different trauma characteristics. Causal inferences are limited, though, because of the cross-sectional design.
  
  
  CONCLUSIONS
  The results suggest that experiencing trauma at young age or multiple times may lead to different symptom profiles but these are, with the exception of dissociation and shame, dependent on PTSD severity. These results support the proposed DSM-V criteria in which these symptoms appear as part of the disorder, and stress the importance of early treatment.
authors.affiliation: Department of Clinical Health and Neuropsychology, Leiden University, PO Box 9555, 2300 RB Leiden, The Netherlands. mhagenaars@fsw.leidenuniv.nl
authors.forename: Muriel A
authors.initials: MA
authors.lastname: Hagenaars
authors.forename: Itzik
authors.initials: I
authors.lastname: Fisch
authors.forename: Agnes
authors.initials: A
authors.lastname: van Minnen
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D009426:Netherlands; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012008:Recurrence; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D014754:Violence / Q000523:psychology; D055815:Young Adult