Measuring Trauma Workshop Summary (2016) / Chapter Skim
Currently Skimming:
2 Existing Studies and Data
2 Existing Studies and Data
Pages 9-24
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 9... ...
The MHSS included the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID) , which Karg said is used by several studies as the "gold standard" in determining the accuracy of clinical diagnoses.
|
From page 10... ...
The screening was for lifetime trauma exposure, in combination with questions about whether the respondent re-experienced the traumatic event or became very distressed when recalling the traumatic event. If this screening yielded a positive result, the SCID was administered for the past year, until the criteria were no longer met.
|
From page 11... ...
The data can provide estimates of the percentage of adults who had exposure to one or more traumatic events in their lifetime; past year subclinical PTSD (including clinical PTSD) among adults with lifetime trauma exposure; and past year clinical PTSD among adults with lifetime trauma exposure.
|
From page 12... ...
. CBHSQ Data Review: Correlates of Lifetime Exposure to One or More Potentially Traumatic Events and Subsequent Posttraumatic Stress Among Adults in the United States: Results from the Mental Health Surveillance Study, 2008-2012.
|
From page 13... ...
-- estimated that between 68 and 84 percent of adults had lifetime exposure to one or more traumatic events. The Collaborative Psychiatric Epidemiology Surveys, the National Survey of American Life, and the 2001-2003 NCS-R -- all of which required both PTSD criteria A1 and A2 (the person's response to the traumatic event involved intense fear, helplessness, or horror)
|
From page 14... ...
The NESARC and the NCS-R used fully structured interviews to assess and define traumatic events and posttraumatic stress symptoms. The MHSS used a semi-structured diagnostic interview that relied on clinical judgment in coding exposure to a traumatic event and the presence of posttraumatic stress symptoms.
|
From page 15... ...
If a stressor is not a criterion A event, it cannot, by definition, produce PTSD, so other PTSD criteria are not assessed. Many researchers call criterion A events traumatic events or potentially traumatic events.
|
From page 16... ...
A critical issue is whether the survey uses behaviorally specific questions to assess potentially traumatic events, especially for people with the highest probabilities of increased risk of PTSD (such as those involving sexual violence, other interpersonal violence, and military combat)
|
From page 17... ...
In terms of intimate partner violence, 36 percent of women and 29 percent of men have been victims of rape, physical violence, or stalking by an intimate partner. Kilpatrick noted that there is a lot of research indicating that these types of potentially traumatic events cannot be measured with simple gatekeeping questions.
|
From page 18... ...
The data collected included DSM-IV diagnoses, using the World Health Organization Composite International Diagnostic Interview. The assessment of lifetime exposure to potentially traumatic events was very comprehensive, through a series of 26 questions about exposure to specific DSM-IV A1 criterion potentially traumatic events.
|
From page 19... ...
Kilpatrick said that an approach such as the one used by the MHSS unavoidably leads to lower estimates of potentially traumatic events and PTSD than those obtained by other studies. Attempting to assess partial PTSD or subclinical PTSD using this method would be nearly impossible because respondents are not asked about the full range of symptoms.
|
From page 20... ...
. National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria.
|
From page 21... ...
This assessment strategy was able to determine which PTSD symptom occurred in response to multiple potentially traumatic events, which provides an approach that can be implemented in large-scale surveys to address the methodological challenges associated with measuring exposure to more than one event and with the fact that risk of PTSD is related to the number of potentially traumatic events experienced. In closing, Kilpatrick emphasized that he believes that any epidemiological study attempting to measure PTSD needs to include a thorough, detailed assessment of exposure to potentially traumatic events, using behaviorally specific terms.
|
From page 22... ...
Kilpatrick also addressed the role of clinically trained interviewers in collecting PTSD data in large-scale surveys. Although clinician-administered semi-structured interviews are generally considered the "gold standard," these interviews are not only expensive, but they can also be less reliable than standardized interviews conducted by lay interviewers because, as noted earlier, different clinicians using different follow-up probes and substituting their own judgments for what the respondent said can lead to greater error variance.
|
From page 23... ...
commented that studies on exposure to potentially traumatic events, PTSD, and risk factors have been consistent in their findings over the past several decades and that more targeted research is needed to produce information that could be used for prevention, instead of focusing on prevalence rates. Keane responded that there have been changes in traumatic experiences and their impact on people's lives, noting in particular a change since 9/11.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.