Study Objectives Effective pharmacological treatments for sleep disturbance related to trauma with and without co-occurring posttraumatic stress disorder (PTSD) are needed. There is debate regarding what effects on rapid eye movement... more
Study Objectives Effective pharmacological treatments for sleep disturbance related to trauma with and without co-occurring posttraumatic stress disorder (PTSD) are needed. There is debate regarding what effects on rapid eye movement sleep (REMS) would be beneficial. Suvorexant is the first dual orexin receptor antagonist (DORA) approved for the treatment of insomnia. In contrast to most psychotropic agents, DORAs can enhance REMS while reducing arousal. We evaluated 6 weeks of suvorexant treatment for trauma-related insomnia in a double-blind, placebo-controlled clinical trial with clinical and polysomnographic evaluation. Methods Participants with insomnia that followed a traumatic event were recruited from the community. Representation of current, past-only, and never having met criteria for PTSD was similar and most participants had experienced trauma-related nightmares. Participants were randomly assigned to receive suvorexant or placebo, initially at 10 mg and increased to 20 ...
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Sleep disordered breathing including transient hypoxemia and hypercarbia are reported in 60-80% of adolescents and children with sickle cell disease (SCD); oxygen desaturation <93% is associated with exercise intolerance. Longer... more
Sleep disordered breathing including transient hypoxemia and hypercarbia are reported in 60-80% of adolescents and children with sickle cell disease (SCD); oxygen desaturation <93% is associated with exercise intolerance. Longer duration of oxygen desaturation, lower nadirs of oxygenation, and end-tidal carbon dioxide levels >50 mm Hg during sleep are associated with increased frequency of acute vaso-occlusion events and are suspected of contributing to microvasculature alterations. To assess the prevalence and degree of sleep-related hypoxemia and potential associations with cardiovascular functions in young adults with SCD, we performed overnight sleep studies using a Type II sleep monitor NOX-T3 (Carefusion, Inc), 6-minute walk tests, echocardiograms, hematologic and chemistry panels, and PSQI questionnaires in 17 adults with SCD, ages 21-30 years. Subjects were attending a sickle cell clinic solely for routine care with no expressed complaints of SDB. Exclusion criteria in...
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ABSTRACTSleep disturbances, including nightmares and insomnia, are prominent following trauma and with posttraumatic stress disorder (PTSD) and likely contribute to the pathogenesis of the disorder. Findings from laboratory studies of... more
ABSTRACTSleep disturbances, including nightmares and insomnia, are prominent following trauma and with posttraumatic stress disorder (PTSD) and likely contribute to the pathogenesis of the disorder. Findings from laboratory studies of PTSD have been inconsistent in terms of documenting objective impaired sleep maintenance but have been somewhat more consistent in indicating alterations of rapid eye movement (REM) sleep. Studies of the early aftermath of trauma can reduce the complexity associated with chronicity and comorbidity, and may have implications for early diagnosis and prevention. Multiple studies indicate that dream content is affected by recent threatening experiences. The development of PTSD is associated with a more replicative type of nightmare content. Sleep is reported to be generally disrupted following trauma especially among those developing PTSD. The limited number of studies that provide objective recorded indices during the early aftermath of trauma also provid...
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To evaluate the relationship between posttraumatic stress disorder (PTSD) and nocturnal blood pressure (BP) dipping in young adult African Americans (AAs). PTSD is associated with physical illnesses including cardiovascular conditions.... more
To evaluate the relationship between posttraumatic stress disorder (PTSD) and nocturnal blood pressure (BP) dipping in young adult African Americans (AAs). PTSD is associated with physical illnesses including cardiovascular conditions. Sleep disturbances related to heightened arousal likely contribute to physical health risk; however, this possibility has not been studied. The studies that have found a relationship between PTSD and hypertension (HTN) have substantial representation of AAs. AAs have elevated rates of HTN and are more likely to exhibit an absence of the normal &amp;amp;amp;amp;amp;amp;quot;dip&amp;amp;amp;amp;amp;amp;quot; of BP at night. Nocturnal BP &amp;amp;amp;amp;amp;amp;quot;nondipping&amp;amp;amp;amp;amp;amp;quot; is an established risk factor for HTN and its cardiovascular complications. Nocturnal BP nondipping and sleep disturbances of PTSD have both been linked to sympathetic nervous system function. Thirty healthy young adult AAs (60% female; mean age = 20.0 years; 17 with lifetime full or subthreshold PTSD, 4 with current symptoms) received 24-hour BP and actigraphy monitoring, filled out sleep diaries, and had structured clinical assessment of PTSD. There were significant associations of lifetime full and subthreshold PTSD and BP nondipping, and the degree of nocturnal dipping correlated with lifetime and current PTSD severity. Elevated nocturnal BP may be a link between PTSD and cardiovascular morbidity in AAs that can be targeted in prevention.
Research Interests: Adolescent, Medicine, Comorbidity, Humans, African American, and 15 moreHypertension, Posttraumatic stress disorder, Blood Pressure, Circadian Rhythm, Female, Male, African Americans, Nocturnal, Actigraphy, Arousal, Age Factors, Cardiovascular Diseases, Life Change Events, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Research Interests: Medicine, Comorbidity, Humans, Internal Medicine, Antidepressant, and 15 moreFemale, Male, Depressive Disorder, Middle Aged, Myocardial Infarction, Cardiovascular Diseases, Risk Factors, Archives General Psychiatry, Proportional Hazards Models, Psychology and Cognitive Sciences, Disease Free Survival, Cause of death, Medical and Health Sciences, Antidepressive agents, and hazard ratio
Post-traumatic stress disorder (PTSD) is a common and potentially disabling disorder that develops in 1/5 to 1/3 of people exposed to severe trauma. Twin studies indicate that genetic factors account for at least one third of the variance... more
Post-traumatic stress disorder (PTSD) is a common and potentially disabling disorder that develops in 1/5 to 1/3 of people exposed to severe trauma. Twin studies indicate that genetic factors account for at least one third of the variance in the risk for developing PTSD, however, the specific role for genetic factors in the pathogenesis of PTSD is not well understood. We studied genome-wide gene expression and DNA methylation profiles in 12 participants with PTSD and 12 participants who were resilient to similar severity trauma exposure. Close to 4000 genes were differentially expressed with adjusted p<0.05, fold-change >2, with all but 3 upregulated with PTSD. Eight odorant/olfactory receptor related genes were up-regulated with PTSD as well as genes related to immune activation, the Gamma-Aminobutyric Acid A (GABAA) receptor, and vitamin D synthesis. No differences with adjusted significance for DNA methylation were found. We conclude that increased gene expression may play ...
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Objective: Trauma exposure is high in African Americans who live in stressful urban environments. Posttraumatic stress disorder (PTSD) and depression are common outcomes of trauma exposure and are understudied in African Americans.... more
Objective: Trauma exposure is high in African Americans who live in stressful urban environments. Posttraumatic stress disorder (PTSD) and depression are common outcomes of trauma exposure and are understudied in African Americans. African Americans are more likely to seek treatment for psychiatric disorders in a primary care setting. Our study evaluated trauma exposure, PTSD and major depression in African Americans attending primary care offices. Method: Six-hundred-seventeen patients (96% African Americans) were surveyed for trauma exposure in the waiting rooms of four primary care offices. Those patients reporting significant traumatic events were invited to a research interview. Of the 403 patients with trauma exposure, 279 participated. Results: Of the 617 participants, 65% reported > or = 1 clearly traumatic event. The most common exposures were transportation accidents (42%), sudden unexpected death of a loved one (39%), physical assault (30%), assault with a weapon (29%) and sexual assault (25%). Lifetime prevalence of PTSD and a major depressive episode (MDE) among those with trauma exposure (n=279) was 51% and 35%, respectively. The percent of lifetime PTSD cases (n=142) with comorbid MDE was 46%. Lifetime PTSD and MDE in the trauma-exposed population were approximately twice as common in females than males, whereas current PTSD rates were similar. Conclusions: Our rate of PTSD (approximately 33% of those screened) exceeds estimates for the general population. Rates of MDE comorbid with PTSD were comparable to other studies. These findings suggest the importance of screening African Americans for PTSD, in addition to depression, in the primary care setting.
Research Interests: Psychology, Clinical Psychology, Health Sciences, Psychiatry, Epidemiology, and 12 morePosttraumatic Stress Disorder (PTSD), Injury Prevention, Public Health, Suicide prevention, Medicine, Population, Pubmed, Research article, The, Poison Control, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Despite increased risk for psychiatric disorders after trauma exposure, many people are able to adapt with minimal life disruption, and others eventually recover after a symptomatic period. This study examined psychosocial factors... more
Despite increased risk for psychiatric disorders after trauma exposure, many people are able to adapt with minimal life disruption, and others eventually recover after a symptomatic period. This study examined psychosocial factors associated with resilience and recovery from psychiatric disorders in a high-risk sample of African American adults exposed to a range of severe traumas, who participated in structured diagnostic interviews. The sample included 259 patients exposed to at least one severe traumatic event, recruited from primary care offices at Howard University and administered the Structured Clinical Interview for DSM-IV Axis I disorders. Multinomial logistic regression was used to identify potential psychosocial factors associated with resilience and recovery, including purpose in life, mastery, and coping strategies. Forty-seven patients had no lifetime psychiatric disorders (resilient), 85 met criteria for at least one past DSM-IV disorder but no current disorders (recovered), and 127 met criteria for at least one current DSM-IV disorder (currently ill). The resilient group was characterized by a significantly lower lifetime trauma load. Female gender was predictive of currently ill status. In the final model, purpose in life emerged as a key factor associated with both resilience and recovery, and mastery was also significantly associated with recovery. The identification of psychosocial factors associated with resistance to severe trauma can inform future studies of preventive and treatment interventions for high-risk populations. Further study is needed to determine which psychosocial factors are consistently associated with resilience and to what extent they can be modified through clinical intervention.
Research Interests: Clinical Psychology, Demography, Psychiatry, Medicine, Population, and 15 moreHumans, African American, Female, Male, Psychological Intervention, American, African Americans, Prevalence, Adult, Ethnic Group, Convalescence, Predictive value of tests, Life Change Events, High risk, and Medical and Health Sciences
Introduction Poor sleep is common in our society, particularly for African Americans. Unwanted, intrusive thoughts at bedtime contribute to sleep disturbances, and the nature of intrusive thoughts may be influenced by perception of threat... more
Introduction Poor sleep is common in our society, particularly for African Americans. Unwanted, intrusive thoughts at bedtime contribute to sleep disturbances, and the nature of intrusive thoughts may be influenced by perception of threat among people living in stressful urban environments. Research has suggested that strategies to control intrusive thoughts vary in their adaptiveness and may be modifiable. These findings need to be confirmed in populations residing in stressful urban environments where perceived threats contribute to intrusive thoughts.The present study attempts to replicate prior research examining the relationship between thought control strategies and insomnia in urban residing young-adult African Americans. Methods Sixty-three young-adult African Americans completed the Thought Control Questionnaire for Insomnia-Revised and the Insomnia Severity Index (ISI). Results Thought control strategies previously associated with insomnia were significantly correlated wit...
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Research has shown that religious affiliation is associated with reduced all cause mortality. The aim of this study was to determine if religious affiliation predicts trauma-specific mortality and length of stay. Patients admitted to our... more
Research has shown that religious affiliation is associated with reduced all cause mortality. The aim of this study was to determine if religious affiliation predicts trauma-specific mortality and length of stay. Patients admitted to our urban Level I trauma center in 2008 were examined; the main study categorization was based on endorsement of a specific religious affiliation during a standard intake procedure. Bivariate and multivariate analysis was performed with in-hospital mortality and length of stay as the outcomes of interest, adjusting for demographic and injury severity characteristics. A total of 2303 patients were included in the study. Forty-six per cent endorsed a religious affiliation. Patients with a religious affiliation were more likely to be female, Hispanic, and older than those who reported no affiliation ( P < 0.001). There was no difference in length of hospital stay. On bivariate analysis those without religious affiliation were more likely to die ( P = 0....
Research Interests: Religion, Demography, Prayer, Adolescent, Medicine, and 15 moreMultivariate Analysis, Humans, Female, Male, Regression Analysis, Length of Stay, Clinical Sciences, Trauma Center, Adult, Hospital Mortality, Wounds and Injuries, Trauma Centers, Injury Severity Score, Outcome assessment (Health care), and Bivariate Analysis
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Introduction Cannabis use is increasing, despite limited knowledge of its potential benefits and adverse effects. Reducing sleep disturbance appears to be a frequent motivation for nighttime cannabis use yet its effects on sleep are... more
Introduction Cannabis use is increasing, despite limited knowledge of its potential benefits and adverse effects. Reducing sleep disturbance appears to be a frequent motivation for nighttime cannabis use yet its effects on sleep are poorly documented. We leveraged data from an observational study of urban residing young adult African Americans where pre-bedtime cannabis use was variably endorsed with digital ecological momentary assessment (EMA) to conduct within and between subjects’ comparisons of sleep with and without preceding cannabis use. Methods Participant were recruited from an ongoing observational study that enrolls African Americans living in urban environments. 20 participants endorsed cannabis use on some but not all nights and were included in the within subjects’ comparison. 25 participants who used cannabis on 2 or more nights were compared with 28 participants who did not endorse prebedtime substance use. Total sleep time (TST), and wake after sleep onset WASO wer...
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Chronic insufficient sleep is linked to a variety of adverse health outcomes, with African Americans reporting and objectively receiving poorer sleep outcomes in comparison to their non-Hispanic white counterparts. African Americans live... more
Chronic insufficient sleep is linked to a variety of adverse health outcomes, with African Americans reporting and objectively receiving poorer sleep outcomes in comparison to their non-Hispanic white counterparts. African Americans live disproportionately in low-income and disordered neighborhoods that increase one’s risk of experiencing a traumatic event and interfere with sleep. It has been demonstrated that posttraumatic stress disorder disrupts sleep in part due to its association with sleep-related fears. However, less research has evaluated the additional contribution of perceived neighborhood stress on the sleep-related fears African Americans experience in their sleep environments. The present study features a nonclinical sample of 163 African American participants (ages 18–35) who reside in DC to investigate whether PTSD severity (Clinician Administered PTSD Scale for DSM-5 Severity Score, CAPS-5) and perceived neighborhood stress (City Stress Index, CSI) are predictive of...
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This study's objective was to investigate the relationship between a variable-number tandem-repeat (VNTR) Period 3 gene (PER3) polymorphism and sleep adaptation to stressful urban environments. Seventy-five (49 female) African... more
This study's objective was to investigate the relationship between a variable-number tandem-repeat (VNTR) Period 3 gene (PER3) polymorphism and sleep adaptation to stressful urban environments. Seventy-five (49 female) African American participants (ages 18-35 years) living in neighbourhoods with high rates of violent crime were selected for the study based on converging criteria for good or poor sleep. Categorization of sleep quality was based on the Insomnia Severity Index (ISI), estimates of typical sleep duration and sleep efficiency. Other assessments included the Fear of Sleep Index (FOSI) and City Stress Inventory (CSI). Whole blood DNA was analysed for the 4 and 5 VNTR alleles using polymerase chain reaction (PCR) and restrictive enzyme digestion. Fifty-seven per cent of those who were homo- or heterozygous for the 4-repeat allele were poor sleepers versus 25% of those homozygous for the 5-repeat allele; χ(2) = 4.17, P = 0.041. In a logistic regression model with all th...
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ABSTRACT This study examined the relationship between sleep fears and insomnia in veterans. Participants completed questionnaires assessing mental health, pain, insomnia, and sleep fears. Most veterans (84.54%) endorsed clinically... more
ABSTRACT This study examined the relationship between sleep fears and insomnia in veterans. Participants completed questionnaires assessing mental health, pain, insomnia, and sleep fears. Most veterans (84.54%) endorsed clinically significant insomnia. Veterans with a history of combat zone deployment and who screened positive for possible post-traumatic stress disorder (PTSD) reported more insomnia symptoms, and both factors were associated with increased fear of reexperiencing and losing vigilance. Regression analyses indicated that fear of reexperiencing and losing vigilance were associated with insomnia severity, controlling for depression, pain, and possible PTSD. These results suggest the importance of assessing and targeting these cognitions when treating veterans with insomnia.
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Nightmares that replicate traumatic events are among the criteria that define posttraumatic stress disorder (PTSD); however, there has been limited systematic assessment of the content of dreams in PTSD. A PTSD dream rating instrument was... more
Nightmares that replicate traumatic events are among the criteria that define posttraumatic stress disorder (PTSD); however, there has been limited systematic assessment of the content of dreams in PTSD. A PTSD dream rating instrument was developed to operationalize features attributed to dreams associated with combat-related PTSD that incorporated dimensions from the dream content analysis literature, and its reliability was assessed. Then the instrument was used to characterize dream reports in 18 Vietnam combat veterans diagnosed with PTSD. Approximately half of the group&amp;amp;#39;s target dreams contained features characteristic of combat, and all but 3 (17%) were moderately to highly threatening. Fifty-three percent were set at least partially in the present and 79% contained distorted elements. We therefore conclude that target dreams of combat veterans with PTSD vary with regard to replication of trauma and elements normally associated with dreaming, but typically are threatening.
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Introduction African Americans are disproportionately affected by environmental factors that increase the risk for negative health outcomes. Analyses from National Health Interview Survey (NHIS) data estimated 15 to 75 percent of the... more
Introduction African Americans are disproportionately affected by environmental factors that increase the risk for negative health outcomes. Analyses from National Health Interview Survey (NHIS) data estimated 15 to 75 percent of the disparities between Black and White respondents being accounted for by residential context. Poor sleep health, particularly short sleep duration, has been linked to metabolic and cardiovascular disease. A population study indicated that sleep duration of less than 6 hours was more common among African Americans compared with other racial groups in the United States and this association was accounted for by African Americans living in high density urban environments. Threats of violence may engender feelings of vulnerability when sleeping and be an important determinant of sleep health though this relationship has not been adequately studied. The aim of this study is to determine how an individual’s sleep health relates to violent crime rates in their ne...
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Introduction Finding medication treatment that improves sleep disturbances with posttraumatic stress disorder (PTSD) has challenged the field of psychopharmacology with debate regarding the desirable profile of effects on sleep... more
Introduction Finding medication treatment that improves sleep disturbances with posttraumatic stress disorder (PTSD) has challenged the field of psychopharmacology with debate regarding the desirable profile of effects on sleep physiology. Evidence for fragmentation of REM sleep during the earlier stages of PTSD drew our interest to the first marketed dual orexin antagonist, suvorexant, which has been suggested in some studies to enhance REM sleep. This property has also raised concerns regarding potential exacerbation of nightmares and REM sleep related parasomnias. Insomnia is a common sequela of trauma exposure and can occur with and without other PTSD symptoms. The objective of our study was to evaluate the tolerability and preliminary efficacy of suvorexant for trauma related insomnia in a double blind, placebo controlled trial. Methods 64 met initial inclusion criteria and 42 participants had evaluable results. 65% were female, and 66% African-American, mean age was 35yrs.All ...
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Research Interests: Clinical Psychology, Psychiatry, Psychotherapy, Mental Health, Primary Health Care, and 15 moreEvidence Based Medicine, Evidence Based Practice, Public Health, Adolescent, Medicine, Humans, Female, Male, GAP, Mental health services, Middle Aged, Adult, Psychotropic Drugs, District of Columbia, and Medical and Health Sciences
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Research Interests: Psychology, Adolescent, Medicine, Biological Sciences, Population, and 15 moreHumans, Minority Groups, Female, Male, Young Adult, Sleep, African Americans, Polysomnography, Wakefulness, Adult, Urban Population, District of Columbia, Cross Sectional Studies, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Research Interests: Psychology, Clinical Psychology, Cognitive Science, Psychiatry, Domestic Violence, and 14 morePsychotherapy, Posttraumatic Stress Disorder (PTSD), Treatment Outcome, Medicine, Population, Humans, African American, Posttraumatic stress disorder, United States, Clinical, African Americans, Prevalence, Ethnic Group, and Drug Therapy
Research Interests: Clinical Psychology, Depression, Medicine, Gene expression, Comorbidity, and 15 moreAnxiety, Humans, African American, Major Depressive Disorder, Female, Male, African Americans, Clinical Sciences, Anxiety and Depression, Genotype, Adult, Genetic variation, ANXIETY, Case Control Studies, and alleles
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Research Interests: Psychology, Dreams, Medicine, Biological Sciences, Biological Psychiatry, and 15 moreHumans, Placebo, Posttraumatic stress disorder, Female, Nightmare, Male, Biological, Sleep, Polysomnography, Middle Aged, Adult, Prazosin, Sleep Disturbance, Psychology and Cognitive Sciences, and Medical and Health Sciences
Research Interests: Analytic Philosophy, Education, Depression, Abortion, Anxiety, and 15 moreComplication, Accidents, Cancer Diagnosis, Acute Stress Disorder, Defense Mechanisms, Dissociative disorders, Clinical Sciences, Anxiety and Depression, Aged, Arousal, Burns, Adult, Cancer Patient, ANXIETY, and Disability Evaluation
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In randomized trials, prazosin, an α-adrenoreceptor antagonist, has been effective in alleviating nightmares associated with post-traumatic stress disorder (PTSD) in military veterans. We recruited veterans from 13 Department of Veterans... more
In randomized trials, prazosin, an α-adrenoreceptor antagonist, has been effective in alleviating nightmares associated with post-traumatic stress disorder (PTSD) in military veterans. We recruited veterans from 13 Department of Veterans Affairs medical centers who had chronic PTSD and reported frequent nightmares. Participants were randomly assigned to receive prazosin or placebo for 26 weeks; the drug or placebo was administered in escalating divided doses over the course of 5 weeks to a daily maximum of 20 mg in men and 12 mg in women. After week 10, participants continued to receive prazosin or placebo in a double-blind fashion for an additional 16 weeks. The three primary outcome measures were the change in score from baseline to 10 weeks on the Clinician-Administered PTSD Scale (CAPS) item B2 ("recurrent distressing dreams"; scores range from 0 to 8, with higher scores indicating more frequent and more distressing dreams); the change in score from baseline to 10 week...
Research Interests: Psychotherapy, Dreams, Medicine, Humans, United States, and 14 moreFemale, Male, Veterans, Sleep, Middle Aged, Suicidal Ideation, Adult, New England Journalof Medicine, Sleep-Wake Disorders, Combined Modality Therapy, Psychiatric Status Rating Scales, Prazosin, Treatment Failure, and Medical and Health Sciences
Obesity is highly prevalent and adds greatly to the risk of cardiovascular and metabolic diseases. However, a subset of the obese has been identified who do not appear to carry this risk. Some studies suggest that anthropomorphic... more
Obesity is highly prevalent and adds greatly to the risk of cardiovascular and metabolic diseases. However, a subset of the obese has been identified who do not appear to carry this risk. Some studies suggest that anthropomorphic correlates of risk, such as waist circumference, differ between African Americans and Whites and features of uncomplicated obesity have not been well characterized in this population. The goal of our study was to determine the prevalence and associated features of uncomplicated obesity, including relationships to waist circumference and the achievement of weight loss in primarily African American patients. A retrospective chart review. Outpatient medically supervised weight loss program located at a teaching hospital in Washington, DC. Predominately adult African American females. Thirty-one percent of our population had no documented metabolic or cardiovascular disease. This group was on average younger, but had similar waist circumference (44 +/- 13.8 vs ...
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Research Interests: Forecasting, Mental Health Policy, Health Services Research, Health Policy, Clinical Decision Making, and 15 moreHumans, Female, Male, Cost effectiveness, Medicaid, New Hampshire, Middle Aged, Adult, Atypical Antipsychotics, Health Services Administration, Drug Utilization, Cohort Studies, Combination Therapy, Antipsychotic agents, and Medical and Health Sciences
Reduced heart rate variability during sleep: a candidate PTSD biomarker with implications for health risk: Commentary on Ulmer et al., “Posttraumatic stress disorder diagnosis is associated with reduced parasympathetic activity during sleep in US veterans and military service members of the Iraq ...more
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Posttraumatic stress disorder (PTSD) is associated with high rates of medical service use and with self-reported poor health. Male veterans admitted to a rehabilitation unit for PTSD (N=55) or alcohol dependence (N=38) were evaluated for... more
Posttraumatic stress disorder (PTSD) is associated with high rates of medical service use and with self-reported poor health. Male veterans admitted to a rehabilitation unit for PTSD (N=55) or alcohol dependence (N=38) were evaluated for comorbid psychiatric and medical conditions and health risk factors. Patients with PTSD were more likely to have osteoarthritis, diabetes, heart disease, comorbid depression, obesity, and elevated lipid levels. These findings suggest that there may be a relationship between specific medical conditions, possibly mediated by behavioral risk factors, among the aging population of veterans with PTSD.
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Background. In post-traumatic stress disorder (PTSD) there is a need for self-rating scales that are sensitive to treatment effects and have been tested in a broad range of trauma survivors. Separate measures of frequency and severity may... more
Background. In post-traumatic stress disorder (PTSD) there is a need for self-rating scales that are sensitive to treatment effects and have been tested in a broad range of trauma survivors. Separate measures of frequency and severity may also provide an advantage.Methods. Three hundred and fifty-three men and women completed the Davidson Trauma Scale (DTS), a 17-item scale measuring each DSM-IV symptom of PTSD on 5-point frequency and severity scales. These subjects comprised war veterans, survivors of rape or hurricane and a mixed trauma group participating in a clinical trial. Other scales were included as validity checks as follows: Global ratings, SCL-90-R, Eysenck Scale, Impact of Event Scale and Structured Clinical Interview for DSM-III-R.Results. The scale demonstrated good test–retest reliability (r = 0·86), internal consistency (r = 0·99). One main factor emerged for severity and a smaller one for intrusion. In PTSD diagnosed subjects, and the factor structure more closely...