Emotional response at the time of a potentially traumatizing event and PTSD symptomatology

Roemer, Lizabeth; Orsillo, Susan M.; Borkovec, T. D.; Litz, Brett T.

doi:10.1016/s0005-7916(98)00007-x

Cited by 72 publications

(57 citation statements)

References 11 publications

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“…However, for some victims, the crime happened too quickly for intense emotions to be registered while others experienced a numbing response, with effects ranging from extreme to partial reduction in both emotion and awareness. The apparent lack of association between fear and general symptoms is also consistent with findings by Roemer et al [9]. Studies have shown that it is the negative emotions occurring after subsequent cognitive appraisal that often have a link to the development of PTSD symptoms [11,41].…”

Section: Discussionsupporting

confidence: 89%

“…They concluded that peritraumatic emotions were the strongest predictor for PTSD symptoms or rates of current PTSD. Roemer, Orsillo, Borkovec, & Litz [9] found that only helplessness was significantly correlated with post-traumatic symptomatology and that reports of peritraumatic emotional numbing uniquely predicted subsequent PTSD symptoms beyond coincident emotional responses. Recently, Fikretoglu et al [10] showed that panic reactions mediate the relationship between the intense emotion of fear, helplessness and horror and dissociation at the time of trauma.…”

Section: Introductionmentioning

confidence: 99%

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Trauma-related Symptoms after Violent Crime: The Role of Risk Factors before, during and Eight Months after Victimization

Semb¹,

Henningsson²,

Fransson³

et al. 2009

TOPSYJ

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Abstract:The aim of this study was to explore the prevalence of current suffering and the role of peritraumatic emotions and other risk factors for development of post-traumatic and general symptoms eight months post crime. Questionnaires assessing trauma-specific symptoms (HTQ) and general psychiatric symptoms (SCL-90) was used along with a semistructured interview covering subjective reactions of 41 civilian victims of interpersonal crime. Victims proved to still be suffering, in varying degrees, from post-traumatic symptoms and other psychological distress. Females reported more trauma-specific symptoms and other comorbid conditions than males. Prior trauma, adverse childhood, being female, previous psychiatric history, and unemployment were all associated with more distress. Peritraumatic reactions (especially secondary emotions following cognitive appraisals after the event) predicted the three core PTSD symptoms and comorbid conditions. Apart from the PTSD symptoms, an assessment of background factors, general psychiatric symptoms, peritraumatic emotions and their cognitive associated scripts in the initial post-trauma period could be helpful in identifying victims who are at risk of developing trauma symptoms.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Trauma-related Symptoms after Violent Crime: The Role of Risk Factors before, during and Eight Months after Victimization

Semb¹,

Henningsson²,

Fransson³

et al. 2009

TOPSYJ

View full text Add to dashboard Cite

show abstract

“…Although this is inconsistent with Roemer et al (1998) who found that helplessness was a superior predictor to fear and horror, it may be that the current subjective criterion is too narrow in the emotional reactions that it captures (Brewin et al, 2000) and the inclusion of reactions such as peritraumatic dissociation (e.g., Ozer, Best, Lipsey, & Weiss, 2003) or cognitive appraisals (e.g., Blanchard et al, 1995) may help to predict PTSD. However, retrospective reports of emotional reactions, such as peritraumatic dissociation, may be subject to reporting biases consistent with current symptom presentation (e.g., Southwick, Morgan, Nicolaou, & Charney, 1997;Zoellner, Sacks, & Foa, 2001).…”

Section: Discussioncontrasting

confidence: 62%

“…However, retrospective reports of emotional reactions, such as peritraumatic dissociation, may be subject to reporting biases consistent with current symptom presentation (e.g., Southwick, Morgan, Nicolaou, & Charney, 1997;Zoellner, Sacks, & Foa, 2001). Further, it may be the intensity of the reaction that predicts PTSD and not the mere presence of the emotional response (Brewin et al, 2000;Roemer et al, 1998). However, assessment of this intensity is complicated; for most individuals, a ceiling effect occurs with the traumatic event being their most distressing experience rendering quantitative measurement more difficult (McNally, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…This is particularly interesting since men are more likely than women to report a potentially traumatic event (i.e., objective experience without the distress requirement; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995), suggesting that the A2 criterion may reverse this gender difference. Furthermore, the individual items in A2 may differ in predictive ability, with helplessness predicting PTSD better than fear or horror (Roemer, Orsillo, Borkovec, & Litz, 1998). Thus, although PTSD is classified as a fear-based disorder, it may be that other peritraumatic emotional reactions are more predictive of the diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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The utility of the A1 and A2 criteria in the diagnosis of PTSD

Bedard‐Gilligan

Zoellner

2008

Behaviour Research and Therapy

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In the field of posttraumatic stress disorder (PTSD), the revisions to the DSM-IV definition of a potentially traumatic event are contentious. Proponents praise the subjective emphasis, while others contend that the changes to the criterion broadened the conceptualization of PTSD. This study examined the predictive utility of Criterion A events, examining the stressor (A1) and subjective emotional response (A2) components of the definition of a traumatic event. Rates of Criterion A events and PTSD were calculated for three diverse samples, and predictive power, sensitivity, specificity, and ROC curves were computed to determine the predictive utility of Criterion A requirements for PTSD symptom, duration, and functional impairment diagnostic criteria. Across all samples the current Criterion A requirements did not predict much better than chance. Specifically, A2 reports added little to the predictive ability of an A1 stressor, though the absence of A2 predicted the absence of PTSD-related symptoms, their duration, and impairment. Notably, the combination of three A1 and A2 criteria showed the best prediction. Confronted events also showed less predictive ability than experienced events, with more variable performance across samples. These results raise fundamental questions about the threshold or "gate" that Criterion A ought to play in our current nosology.

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A review of acute stress disorder in DSM-5

et al. 2010

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Acute stress disorder (ASD) was introduced into DSM-IV to describe acute stress reactions (ASRs) that occur in the initial month after exposure to a traumatic event and before the possibility of diagnosing posttraumatic stress disorder (PTSD), and to identify trauma survivors in the acute phase who are high risk for PTSD. This review considers ASD in relation to other diagnostic approaches to acute stress responses, critiques the evidence of the predictive power of ASD, and discusses ASD in relation to Adjustment Disorder. The evidence suggests that ASD does not adequately identify most people who develop PTSD. This review presents a number of options and preliminary considerations to be considered for DSM-5. It is proposed that ASD be limited to describing severe ASRs (that are not necessarily precursors of PTSD). The evidence suggests that the current emphasis on dissociation may be overly restrictive and does not recognize the heterogeneity of early posttraumatic stress responses. It is proposed that ASD may be better conceptualized as the severity of acute stress responses that does not require specific clusters to be present.

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Emotional response at the time of a potentially traumatizing event and PTSD symptomatology

Cited by 72 publications

References 11 publications

Trauma-related Symptoms after Violent Crime: The Role of Risk Factors before, during and Eight Months after Victimization

Trauma-related Symptoms after Violent Crime: The Role of Risk Factors before, during and Eight Months after Victimization

The utility of the A1 and A2 criteria in the diagnosis of PTSD

A review of acute stress disorder in DSM-5

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