Background: Most of the work on understanding subthreshold PTSD has focused on inconsistencies in defining subthreshold PTSD and how those inconsistencies impact prevalence rates. The present study distinguishes between full and subthreshold PTSD using empirical categorization and assesses the circumstances under which empirical categorization is discordant with full and subthreshold PTSD diagnoses.
Methods: Using data from the NIDA CTN Women and Trauma Study (N = 353), we use a modernized adaptation of the Jacobson and Truax (1991) framework, assessing whether patients were above or below an empirical threshold on latent PTSD severity scores estimated under categorical confirmatory factor analysis; the empirical categorizations were then crossed with the diagnoses to form four diagnostic by empirical categorization groupings.
Results: Compared to a reference group (full PTSD diagnosis and empirical categorization), patients who had a full PTSD diagnosis but a subthreshold empirical categorization had lower symptom endorsement rates on 15 PTSD symptoms, were more likely to be married, ethnic minorities with fewer lifetime traumas. Conversely, patients with a subthreshold PTSD diagnosis and a full PTSD empirical grouping looked similar to "Full/Fulls", only differing on avoidance symptoms.
Limitations: Alternative definitions of subthreshold PTSD and coding of symptom endorsement may impact results. The use of DSM-IV symptoms (though reconciled against overlapping symptoms from DSM-5) is also a key limitation.
Conclusions: Empirical categorization can be a useful supplement to diagnosis in distinguishing subthreshold PTSD from full PTSD, using a methodology that could provide a platform for melding dimensional and categorical nosology approaches in the DSM.
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http://dx.doi.org/10.1016/j.jad.2020.05.031 | DOI Listing |
Eur Psychiatry
January 2025
Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA.
Background: Racial and ethnic experiences of discrimination (EODs) are associated with numerous psychiatric symptoms, including outcomes along the psychosis spectrum; however, less is known about mechanisms by which EODs confer risk for psychotic-like experiences (PLEs; common subthreshold psychotic symptoms). Furthermore, work on gendered racism asserts that the intersection of race and gender impacts the nature of EODs experienced and, in turn, may impact the relationship between EODs and PLEs.
Aims: To utilize an intersectional lens (race and gender) to examine whether psychological correlates of EODs (post-traumatic stress, anxiety, depression, and dissociation) mediate the EOD-PLE relationship.
Soc Psychiatry Psychiatr Epidemiol
December 2024
School of Psychology, University of New South Wales, Sydney, NSW, 2052, Australia.
Purpose: Exposure to traumatic events may lead to the development of Acute Stress Disorder (ASD) within the first month post-trauma in some individuals, while others may not exhibit ASD symptoms. ASD was introduced as a potential early indicator to identify those at higher risk of developing Posttraumatic Stress Disorder (PTSD), however, PTSD can occur in some individuals even without prior ASD. Assessing ASD post-trauma can assist in identifying those who would most benefit from intervention to prevent later PTSD, yet the predictive power of ASD varies across studies, with intensity of ASD symptoms and subthreshold PTSD often less considered.
View Article and Find Full Text PDFInt J Yoga Therap
December 2024
Independent Scholar; and The Branches Yoga, Kitchener, Ontario, Canada.
Trauma exposure is universal to the human condition, with many affected individuals experiencing either posttraumatic stress disorder (PTSD) or subthreshold manifestations. Both scenarios can become functionally debilitating and collectively lay a heavy burden on individuals and society. Yoga nidra is one adjunctive treatment of growing interest, holding potential for its ability to alleviate symptoms of trauma, including hypervigilance, sleep disturbances, and disembodiment.
View Article and Find Full Text PDFJ Pain Symptom Manage
December 2024
Division of Hematology-Oncology (W.C.C., S.T.T.), Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan, R.O.C.;; School of Nursing, Medical College (S.T.T.), Chang Gung University, Tao-Yuan, Taiwan, R.O.C.; Department of Nursing (S.T.T.), Chang Gung University of Science and Technology, Tao-Yuan, Taiwan, R.O.C.. Electronic address:
Context: Health-related quality of life (HRQOL) is highly endorsed, but HRQOL studies scarcely investigate the following: ICU family members; modifiable end-of-life (EOL) ICU-care factors; conjoint associations with prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), and depression; and long-term bereavement outcomes.
Objectives: Exploratorily investigate associations of PGD-PTSD-depressive-symptom states (resilient, subthreshold-depression dominant, PGD dominant, and PGD-PTSD-depression comorbid) and quality of EOL ICU care with families' HRQOL 6-24 months post loss.
Methods: This cohort study examined symptoms of PGD (11 items of the PG-13), PTSD (Impact of Event Scale-Revised), and depression (Hospital Anxiety and Depression Scale), and HRQOL (Medical Outcomes Study 36-Item Short-Form Health Survey) among 303 ICU family members.
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