This study examined the factor structure, internal consistency, concurrent validity, and discriminative validity of the Impact of Event Scale -Revised (IES-R, Weiss & Marmar, 1997) in a sample of 182 individuals who had experienced a serious motor vehicle accident. Results supported the three-factor structure of the IES-R, Intrusion, Avoidance, and Hyperarousal, with adequate internal consistency noted for each subscale. Support was obtained for the concurrent and discriminative validity, as well as the absence of social desirability effects. Although some differences were noted between the IES-R Avoidance subscale and diagnostically-based measures of this cluster of symptoms, these differences do not necessarily signify measurement problems with the IES-R. The IES-R seems to be a solid measure of post-trauma phenomena that can augment related assessment approaches in clinical and research settings.

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The current report used confirmatory factor analysis to examine the latent structures of both key features and associated symptoms of three disorders that commonly develop following a traumatic event: posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). Participants were 228 motor-vehicle accident survivors who sought treatment for emotional difficulties. PTSD, MDD, and GAD were assessed with a combination of self-report and interview-based measures. The results of construct level analyses suggested that PTSD, MDD, and GAD are distinguishable but highly correlated disorders following a traumatic event. Symptom level analyses supported a model where the Reexperiencing, Avoidance, and Hypervigilance factors were subsumed under the PTSD construct. However, in this model the Dysphoria factor was a higher order construct correlated with the PTSD, MDD, and GAD factors, suggesting that the Dysphoria cluster may not be unique to PTSD. Diagnostic and theoretical implications of these results are discussed.

Many traumatic events leave lingering physical injuries and chronic pain in their wake, in addition to trauma-related psychopathology. In this review, we provide an overview of developments in the recent literature on co-morbid posttraumatic stress disorder (PTSD) and chronic pain. Starting with the conceptual models presented by Sharp and Harvey (2001) and Asmundson, Coons, Taylor, and Klatz (2002), this review summarizes newer studies that examine prevalence of these co-morbid conditions. Additionally, we present an updated synthesis of research on factors that may maintain both chronic physical pain and PTSD in trauma survivors. Consideration of the impact of this co-morbidity on psychosocial assessment and treatment also is discussed, with particular attention to issues that warrant additional research.It is well recognized that posttraumatic stress disorder (PTSD) often is complicated by additional pathologies (Kessler, Chiu, Demler, Merikangas, & Walters, 2005). Whereas a substantial literature has examined the implications of psychiatric co-morbidity on the assessment and treatment of PTSD, research exploring the impact of physical health comorbidity, specifically chronic pain, is limited. Because many traumatic events involve physical injuries that leave chronic pain in their wake, the interplay of PTSD and physical pain becomes salient for many trauma survivors. Two significant reviews (e.g., Asmundson, Coons, Taylor, & Klatz, 2002;Sharp & Harvey, 2001) first focused attention on this cooccurrence and comorbidity. These reviews have guided research by highlighting factors that may contribute to the development and/or mutual maintenance of PTSD and physical pain. The present review aims to synthesize developments in the empirical literature following these earlier publications. Specifically we review current prevalence estimates of co-morbid PTSD/pain as well as developments in the empirical evidence supporting factors identified in these two reviews. Research examining the impact of PTSD/pain co-morbidity on assessment and treatment also is reviewed with attention to areas where further research is needed. Definition of termsPTSD is an anxiety disorder characterized by a collection of specific symptoms following exposure to a traumatic event (American Psychiatric Association, 2000). Within the current Correspondence concerning this article can be sent to J. Gayle Beck, Ph.D., Department of Psychology, University of Memphis, 400 Innovation Drive, Memphis, TN 38104 or jgbeck@memphis.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is a...

Although long recognized in the clinical literature, problematic behavior characteristic of anxious drivers has received little empirical attention. The current research details development of a measure of anxious driving behavior conducted across three studies. Factor analytic techniques identified three dimensions of maladaptive behaviors across three college samples: anxiety-based performance deficits, exaggerated safety/caution behavior, and anxiety-related hostile/aggressive behavior. Performance deficits evidenced convergent associations with perceived driving skill and were broadly related to driving fear. Safety/caution behaviors demonstrated convergence with overt travel avoidance, although this relationship was inconsistent across studies. Safety/caution scores were associated specifically with accident- and social-related driving fears. Hostile/aggressive behaviors evidenced convergent relationships with driving anger and were associated specifically with accident-related fear. Internal consistencies were adequate, although some test-retest reliabilities were marginal in the unselected college sample. These data provide preliminary evidence for utility of the measure for both research and clinical practice.