Steven E. Bruce, Ph.D.; Risa B. Weisberg, Ph.D.; Regina T. Dolan, Ph.D.; Jason T. Machan, M.S.; Ronald C. Kessler, Ph.D.; Gertrude Manchester, M.D.; Larry Culpepper, M.D.; and Martin B. Keller, M.D
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Background: This article examines the
nature of psychological trauma and posttraumatic
stress disorder (PTSD) in 504 patients recruited
from primary care settings.
Method: Patients were screened for anxiety
in waiting rooms at 14 general medical settings,
and those with a sufficient number and severity of anxiety symptoms were administered a
standardized diagnostic clinical interview. Those who
met DSM-IV criteria for an anxiety disorder and
who were willing to participate were included in
this study. Of the 504 patients, 185 met DSM-IV
criteria for PTSD.
Results: Results indicated that 418 (83%)
of primary care patients in our sample reported at least 1 traumatic event in their lifetime. The
most prevalent traumas experienced by the entire sample of participants were witnessing
others being seriously injured or killed, serious
accidents, and rape. Of those participants with
PTSD, rape was the strongest predictor of a PTSD
diagnosis. Analyses examining gender differences indicated that, for women, a history of other
unwanted sexual contact or witnessing a sexual assault, being attacked with a weapon or with
intent to kill, or witnessing someone being injured
were found to be risk factors for a PTSD
diagnosis. Examination of clinical characteristics indicated
a high rate of comorbidity of psychiatric
disorders among patients with PTSD, including high
rates of alcohol/substance abuse, depression, and
suicide attempts.
Conclusion: These findings emphasize
the continued need to assess patients presenting
at general medical facilities about trauma history.
Prim Care Companion J Clin Psychiatry 2001;3(5):211-217
https://doi.org/10.4088/PCC.v03n0504
© Copyright 2001 Physicians Postgraduate Press, Inc.