The Dissociative Subtype of PTSD Scale: Initial Evaluation in a National Sample of Trauma-Exposed Veterans

The fifth edition of the Diagnostic and Statistical Manual includes a dissociative subtype of posttraumatic stress disorder, but no existing measures specifically assess it. This article describes the initial evaluation of a 15-item self-report measure of the subtype called the Dissociative Subtype of Posttraumatic Stress Disorder Scale (DSPS) in an online survey of 697 trauma-exposed military veterans representative of the U.S. veteran population. Exploratory factor analyses of the lifetime DSPS items supported the intended structure of the measure consisting of three factors reflecting derealization/depersonalization, loss of awareness, and psychogenic amnesia. Consistent with prior research, latent profile analyses assigned 8.3% of the sample to a highly dissociative class distinguished by pronounced symptoms of derealization and depersonalization. Overall, results provide initial psychometric support for the lifetime DSPS scales; additional research in clinical and community samples is needed to further validate the measure.

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The Clenching-Grinding Spectrum and Fear Circuitry Disorders: Clinical Insights from the Neuroscience/Paleoanthropology Interface

CNS Spectrums ◽

10.1017/s109285290002263x ◽

2005 ◽

Vol 10 (4) ◽

pp. 311-318 ◽

Cited By ~ 23

Author(s):

H. Stefan Bracha ◽

Tyler C. Ralston ◽

Andrew E. Williams ◽

Jennifer M. Yamashita ◽

Adam S. Bracha

Keyword(s):

Posttraumatic Stress Disorder ◽

Mental Disorders ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Homo Sapiens ◽

Chronic Fatigue ◽

Self Report ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Spectrum Disorders

AbstractThis review discusses the clenching-grinding spectrum from the neuropsychiatric/neuroevolutionary perspective. In neuropsychiatry, signs of jaw clenching may be a useful objective marker for detecting or substantiating a self-report of current subjective emotional distress. Similarly, accelerated tooth wear may be an objective clinical sign for detecting, or substantiating, long-lasting anxiety. Clenching-grinding behaviors affect at least 8% of the population. We argue that during the early paleolithic environment of evolutionary adaptedness, jaw clenching was an adaptive trait because it rapidly strengthened the masseter and temporalis muscles, enabling a stronger, deeper and therefore more lethal bite in expectation of conflict(warfare)with conspecifics. Similarly, sharper incisors produced by teeth grinding may have served as weaponry during early human combat. We posit that alleles predisposing to fear-induced clenching-grinding were evolutionarily conserved in the human clade (lineage) since they remained adaptive for anatomically and mitochondrially modern humans (Homo sapiens) well into the mid-paleolithic. Clenching-grinding, sleep bruxism, myofacial pain, craniomaxillofacial musculoskeletal pain, temporomandibular disorders, oro-facial pain, and the fibromyalgia/chronic fatigue spectrum disorders are linked. A 2003 Cochrane meta-analysis concluded that dental procedures for the above spectrum disorders are not evidence based. There is a need for early detection of clenching-grinding in anxiety disorder clinics and for research into science-based interventions. Finally, research needs to examine the possible utility of incorporating physical signs intoDiagnostic and Statistical Manual of Mental Disorders, Fifth Editionposttraumatic stress disorder diagnostic criteria. One of the diagnostic criterion that may need to undergo a revision inDiagnostic and Statistical Manual of Mental Disorders, Fifth Editionis Criterion D (persistent fear-circuitry activation not present before the trauma). Grinding-induced incisor wear, and clenching-induced palpable masseter tenderness may be examples of such objective physical signs of persistent fear-circuitry activation (posttraumatic stress disorder Criterion D).

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Utility of the Posttraumatic Stress Scale–Self-report version in screening for posttraumatic stress disorder among persons seeking HIV testing

South African Journal of Psychology ◽

10.1177/0081246318779191 ◽

2018 ◽

Vol 49 (1) ◽

pp. 136-147 ◽

Cited By ~ 1

Author(s):

Ashraf Kagee ◽

Jason Bantjes ◽

Wylene Saal ◽

Mpho Sefatsa

Keyword(s):

Posttraumatic Stress Disorder ◽

Mental Disorders ◽

Hiv Testing ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Clinical Interview ◽

Self Report ◽

Statistical Manual ◽

Stress Scale ◽

Diagnostic And Statistical Manual

The literature on the utility of self-report instruments in determining caseness for posttraumatic stress disorder in South Africa is sparse. We administered the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders–Research Version and the Posttraumatic Stress Scale–Self-report version to a sample of 500 South African community members seeking HIV testing. Of our original sample of 500, 306 (61.2%) reported an index event for posttraumatic stress disorder and 25 (5.0%) met the criteria for this diagnosis. The Posttraumatic Stress Scale–Self-report displayed internal consistency of .95 as measured by Cronbach’s alpha. Using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders as a gold standard, we conducted receiver operating curve analysis among the 306 participants who reported an index traumatic event to determine the extent to which the Posttraumatic Stress Scale–Self-report as a screening instrument successfully discriminated between participants who did and did not meet the diagnostic criteria for posttraumatic stress disorder. The Posttraumatic Stress Scale–Self-report yielded sensitivity of .76 and specificity of .78, with an area under the curve of .837. Positive and negative predictive values were .24 and .97, respectively. Our findings suggest that the Posttraumatic Stress Scale–Self-report may be effectively used to screen for posttraumatic stress disorder among community samples, including persons seeking HIV testing.

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Faculty Opinions recommendation of Diagnostic accuracy and acceptability of the primary care posttraumatic stress disorder screen for the diagnostic and statistical manual of mental disorders (fifth edition) among US veterans.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.739489276.793584449 ◽

2021 ◽

Author(s):

Jaimie Gradus

Keyword(s):

Primary Care ◽

Posttraumatic Stress Disorder ◽

Mental Disorders ◽

Diagnostic Accuracy ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Us Veterans

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Intensive EMDR to Treat Patients With Complex Posttraumatic Stress Disorder: A Case Series

Journal of EMDR Practice and Research ◽

10.1891/1933-3196.11.2.84 ◽

2017 ◽

Vol 11 (2) ◽

pp. 84-95 ◽

Cited By ~ 11

Author(s):

Hannelies Bongaerts ◽

Agnes Van Minnen ◽

Ad de Jongh

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Case Series ◽

Self Report ◽

Complex Ptsd ◽

Symptom Scale ◽

Ongoing Research ◽

Research Attention ◽

Emdr Therapy

There is mounting evidence suggesting that by increasing the frequency of treatment sessions, posttraumatic stress disorder (PTSD) treatment outcomes significantly improve. As part of an ongoing research project, this study examined the safety and effectiveness of intensive eye movement desensitization and reprocessing (EMDR) therapy in a group of seven (four female) patients suffering from complex PTSD and multiple comorbidities resulting from childhood sexual abuse, physical abuse, and/or work and combat-related trauma. Treatment was not preceded by a preparation phase and consisted of 2 × 4 consecutive days of EMDR therapy administered in morning and afternoon sessions of 90 minutes each, interspersed with intensive physical activity and psychoeducation. Outcome measures were the Clinician-Administered PTSD Scale (CAPS) and the PTSD Symptom Scale Self-report questionnaire (PSS-SR). During treatment, neither personal adverse events nor dropout occurred. CAPS scores decreased significantly from pre- to posttreatment, and four of the seven patients lost their PTSD diagnosis as established with the CAPS. The results were maintained at 3-month follow-up. Effect sizes (Cohen’s d) on the CAPS and PSS-SR were large: 3.2, 1.7 (prepost) and 2.3, 2.1 (prefollow-up), respectively. The results of this case series suggest that an intensive program using EMDR therapy is a potentially safe and effective treatment alternative for complex PTSD. The application of massed, consecutive days of treatments using EMDR therapy for patients suffering from PTSD, particularly those with multiple comorbidities, merits more clinical and research attention.

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Lifelong posttraumatic stress disorder: evidence from aging Holocaust survivors

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2000.2.1/ybarak ◽

2000 ◽

Vol 2 (1) ◽

pp. 57-62 ◽

Cited By ~ 2

Keyword(s):

Posttraumatic Stress Disorder ◽

World War Ii ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Holocaust Survivors ◽

Positive Association ◽

Ample Evidence ◽

Diagnostic And Statistical Manual ◽

World War Ii Veterans ◽

Axis I

Despite the fact that 50 years have passed since the Nazi regime and the Holocaust the psychic sequelae are far from being overcome. The majority of Holocaust survivors and World War II veterans still list their experiences as the "most significant stressors" of their lives. The literature provides ample evidence that posttraumatic stress disorder among survivors persists into old age. However, there is still a need to define the differences in frequency, clinical presentation, severity, and comorbid conditions among aging Holocaust survivors. Age at the time of trauma, cumulative lifetime stress, and physical illness are reported to have a positive association with more severe posttraumatic symptomatology. The presence of comorbid Axis i psychiatric disorders (Diagnostic and Statistical Manual [DSIVI]), has been the focus of research by our group, demonstrating that their interaction with earlier trauma leads to a course of chronic, debilitating disease. Despite reactivation of traumatic symptoms during aging and continuous mental suffering, the majority of Holocaust survivors show good instrumental coping and preserved functioning.

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Three Studies on the Reliability and Validity of a Self-Report Measure of Posttraumatic Stress Disorder

Assessment ◽

10.1177/107319119600300102 ◽

1996 ◽

Vol 3 (1) ◽

pp. 17-25 ◽

Cited By ~ 73

Author(s):

Dean Lauterbach ◽

Scott Vrana

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Discriminant Validity ◽

Stress Disorder ◽

Traumatic Event ◽

Clinical Sample ◽

Reliability And Validity ◽

Self Report ◽

Highly Correlated ◽

The Impact

This paper describes three studies of the reliability and validity of a newly revised version of the Purdue Posttraumatic Stress Disorder scale (PPTSD-R). The PPTSD-R is a 17-item questionnaire that yields four scores: Reexperiencing, Avoidance, Arousal, and Total. It is highly internally consistent (α = .91), and the scores are relatively stable across time. The PPTSD-R is highly correlated with other measures of PTSD symptomatology and moderately correlated with measures of related psychopathology, providing preliminary support for the measure's convergent and discriminant validity. It reliably distinguishes between groups of people who were and were not traumatized, it is sensitive to the impact of different types of traumatic events, and (within a clinical sample) it discriminates between those who did and did not seek treatment for difficulty coping with the traumatic event being assessed. The PPTSD-R shows promise as a measure of PTSD symptoms in the college population.

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Overview of Posttraumatic Stress Disorder

10.2310/tywc.13026 ◽

2018 ◽

Author(s):

Dana Downs ◽

Carol North

Keyword(s):

Posttraumatic Stress Disorder ◽

Deep Brain Stimulation ◽

Transcranial Magnetic Stimulation ◽

Posttraumatic Stress ◽

Magnetic Stimulation ◽

Stress Disorder ◽

Statistical Manual ◽

Diagnostic And Statistical Manual ◽

Exposure To Trauma ◽

Deep Brain

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may follow exposure to trauma. The experience of trauma has potential personal implications. Some individuals develop PTSD after trauma; others may be more resilient, experiencing distress but not succumbing to psychopathology; and yet others may emerge from the experience with new strength and direction. This review contains 1 figure, 5 tables, and 46 references Keyword: Posttraumatic stress disorder, transcranial magnetic stimulation (TMS), deep brain stimulation, vagal nerve stimulation, transcranial direct current stimulation, Diagnostic and Statistical Manual of Mental Disorders, hypothalamic-pituitary-adrenal (HPA) axis

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