TY - JOUR
T1 - Untangling the psychiatric comorbidity of posttraumatic stress disorder in a sample of flood survivors
AU - McMillen, Curtis
AU - North, Carol S
AU - Mosley, Muriel
AU - Smith, Elizabeth
N1 - Funding Information:
From the George Warren Brown School of Social Work and the Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO. Supported by a grant from the National Institute of Mental Health (R01 MH400025). †Deceased, March 7, 1997. Address reprint requests to Curtis McMillen, Ph.D., Campus Box 1196, Washington University, St. Louis, MO 63130. Copyright 2002, Elsevier Science (USA). All rights reserved. 0010-440X/02/4306-0022$35.00/0 doi:10.1053/comp.2002.34632
PY - 2002
Y1 - 2002
N2 - This report empirically examines multiple explanations for the high rates of psychiatric comorbidity seen with posttraumatic stress disorder (PTSD). One hundred sixty-two St. Louis area survivors of the 1993 Great Midwest Floods were interviewed a few months after the flood subsided using the Diagnostic Interview Schedule (DIS) and its Disaster Supplement to assess psychiatric history relative to PTSD and five other psychiatric disorders. Thirty-five subjects (23%) met criteria for PTSD related to the flood. PTSD was frequently comorbid with other disorders. Seventeen subjects (10%) developed a new, non-PTSD psychiatric disorder after the flood. New non-PTSD disorders were rare in the absence of PTSD symptoms. Though prior psychiatric history was predictive of developing PTSD, no support was found that prior psychiatric history contributed to PTSD through social vulnerability. Thus, support was found for a model in which PTSD contributes to the development of other disorders following trauma, whereas no evidence was found to suggest that comorbid disorders develop independently of PTSD following trauma, or that comorbidity was due to symptom overlap among disorders. The lack of support for models in which psychosocial resources mediate the effect of psychiatric history on the development of PTSD indirectly confirms models of physiological vulnerability to PTSD development.
AB - This report empirically examines multiple explanations for the high rates of psychiatric comorbidity seen with posttraumatic stress disorder (PTSD). One hundred sixty-two St. Louis area survivors of the 1993 Great Midwest Floods were interviewed a few months after the flood subsided using the Diagnostic Interview Schedule (DIS) and its Disaster Supplement to assess psychiatric history relative to PTSD and five other psychiatric disorders. Thirty-five subjects (23%) met criteria for PTSD related to the flood. PTSD was frequently comorbid with other disorders. Seventeen subjects (10%) developed a new, non-PTSD psychiatric disorder after the flood. New non-PTSD disorders were rare in the absence of PTSD symptoms. Though prior psychiatric history was predictive of developing PTSD, no support was found that prior psychiatric history contributed to PTSD through social vulnerability. Thus, support was found for a model in which PTSD contributes to the development of other disorders following trauma, whereas no evidence was found to suggest that comorbid disorders develop independently of PTSD following trauma, or that comorbidity was due to symptom overlap among disorders. The lack of support for models in which psychosocial resources mediate the effect of psychiatric history on the development of PTSD indirectly confirms models of physiological vulnerability to PTSD development.
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U2 - 10.1053/comp.2002.34632
DO - 10.1053/comp.2002.34632
M3 - Article
C2 - 12439837
AN - SCOPUS:0036853466
SN - 0010-440X
VL - 43
SP - 478
EP - 485
JO - Comprehensive Psychiatry
JF - Comprehensive Psychiatry
IS - 6
ER -