title: Predictors of the long-term course of comorbid PTSD: a naturalistic prospective study.
abstract: OBJECTIVE
  The study examined the long-term course of posttraumatic stress disorder (PTSD) by analyzing rates of recurrence and the predictive value of comorbid psychiatric disorders and psychosocial functioning.
  
  
  METHODS
  This study is based on diagnostic assessments administered at intake and subsequent follow-up interviews over a period of 15 years in a sample of 90 anxiety-disordered patients with comorbid PTSD who participated in the Harvard Brown Anxiety Research project (HARP). Kaplan-Meier life table analysis revealed a 0.20 probability of full remission during the 15 years of follow-up.
  
  
  RESULTS
  Latent growth model (LGM) analysis revealed that the number of trauma exposures was a predictor of a worse course of PTSD but only during some intervals of the 15-year follow-up. Subjects with full social phobia were more likely to experience worsening of PTSD over time in comparison with subjects with less severe social phobia. Role functioning in the areas of household and employment was a significant predictor of a declining course of PTSD.
  
  
  CONCLUSIONS
  These findings revealed the dynamic nature of the predictive value of traumatic experiences, the deleterious effect of social phobia and the long term effect of psychosocial functioning on the course of PTSD. Implications for treatment planning and development of interventions for PTSD are discussed.
authors.affiliation: Department of Educational and Psychological Studies, University of Miami, Coral Gables, FL, USA. c.perezbenitez@miami.edu
authors.forename: Carlos I
authors.initials: CI
authors.lastname: Pérez Benítez
authors.forename: Caron
authors.initials: C
authors.lastname: Zlotnick
authors.forename: Ingrid
authors.initials: I
authors.lastname: Dyck
authors.forename: Robert
authors.initials: R
authors.lastname: Stout
authors.forename: Erica
authors.initials: E
authors.lastname: Angert
authors.forename: Risa
authors.initials: R
authors.lastname: Weisberg
authors.forename: Martin
authors.initials: M
authors.lastname: Keller
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000453:epidemiology / Q000523:psychology; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009511:New England / Q000453:epidemiology; D016584:Panic Disorder / Q000453:epidemiology / Q000523:psychology; D010698:Phobic Disorders / Q000453:epidemiology* / Q000523:psychology; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012919:Social Behavior; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology