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Original Research

Trauma at the Hands of Another: Longitudinal Study of Differences in the Posttraumatic Stress Disorder Symptom Profile Following Interpersonal Compared With Noninterpersonal Trauma

David Forbes, PhD; Susan Fletcher, PGDipPsych; Ruth Parslow, PhD; Andrea Phelps, MA; Meaghan O†Donnell, PhD; Richard A. Bryant, PhD; Alexander McFarlane, MD; Derrick Silove, MD; and Mark Creamer, PhD

Published: November 1, 2011

Article Abstract

Objective: Survivors of traumatic events of an interpersonal nature typically have higher rates of posttraumatic stress disorder (PTSD) than survivors of noninterpersonal traumatic events. Little is known about potential differences in the nature or trajectory of PTSD symptoms in survivors of these different types of traumatic events. The current study aimed to identify the specific symptom profile of survivors of interpersonal and noninterpersonal trauma, and to examine changes in differences in the symptom profile over time.

Method: The study examined PTSD symptom data from 715 traumatic injury survivors admitted to the hospital between April 2004 and February 2006, who were assessed 3, 12, and 24 months after injury using the Clinician-Administered PTSD Scale (primary outcome measure). Multivariate analyses of variance were used to investigate differences in PTSD symptom profile over time between interpersonal and noninterpersonal trauma.

Results: Multivariate analyses of variance revealed significant differences between the 2 groups in overall severity of PTSD symptoms at each of the 3 time points: 3 months, F17,696 = 5.86, P < .001; 12 months, F17,696 = 3.62, P < .001; 24 months, F17,696 = 3.09, P < .001. Survivors of interpersonal trauma demonstrated significantly (P < .01) higher scores on 14 PTSD symptoms at 3 months after injury but on only 6 symptoms by 24 months. Symptoms on which differences persisted were the PTSD unique symptoms more associated with fear and threat.

Conclusions: Interpersonal trauma results in more severe PTSD symptoms in the early aftermath of trauma. Over the course of time, the distinctive persisting symptoms following interpersonal trauma involve fear-based symptoms, which suggest fear conditioning may be instrumental in persistent interpersonal PTSD.

J Clin Psychiatry 2012; 73(3): 372-376

Volume: 72

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