Novel analytic model predicts risk for PTSD in recent trauma survivors
A novel logistic model using early PTSD symptom severity as a predictor — as measured by the initial Clinician-Administered PTSD Scale total score — yielded accurate estimates of follow-up PTSD in recent trauma survivors seen in acute care centers, according to findings published in World Psychiatry.
"We are moving from the near impossible task of trying to predict who will develop PTSD to more accurately identifying a risk score for each individual who was exposed to a traumatic event," Arieh Y. Shalev, MD, the Barbara Wilson Professor of Psychiatry at NYU School of Medicine, said in a press release. "Knowing that a person has an increased risk for PTSD will help mitigate it more rapidly, and with fewer residual consequences."
To determine the likelihood of follow-up PTSD, given early predictors, researchers analyzed patient-level data submitted by members of the International Consortium to Predict PTSD from 10 longitudinal studies of 2,473 trauma survivors treated in acute care centers in six countries. Participants completed an initial clinical assessment within 60 days of trauma exposure as well as a follow-up assessment 4 to 15 months later. The investigators used the Clinician-Administered PTSD Scale (CAPS) to determine PTSD symptom severity and diagnostic status at each assessment.
Shalev and colleagues found that the prevalence of follow-up PTSD was 11.8% in participants who experienced a traumatic event (9.2% for men and 16.4% for women). Using early PTSD symptom severity as a predictor, a logistic model “produced remarkably accurate estimates of follow-up PTSD” (predicted vs. raw probabilities: r = 0.976), the researchers wrote.
"Early symptoms, previously known to globally predict the risk of PTSD among trauma survivors (eg, 11% in road traffic accidents or 38% following terror in our previous work) were unable to tell us who, within a group, was at particularly high risk,” Shalev said. “We now can precisely predict each individual's risk, thus moving PTSD evaluation to a more personalized and individualized risk estimate."
Using this approach, the researchers also found that sex, lower education and a lifetime experience of interpersonal trauma (ie, child abuse or sexual assault) indicated a higher risk for chronic PTSD with similar model accuracy (predicted vs. raw probabilities: r = 0.941), according to the results. In addition, known risk factors such as age, marital status and type of trauma did not increase the risk for PTSD, according to the release.
"Early symptom severity has shown to be a major predictor of PTSD risk, so enhanced evaluation provides a valid warning and a call for action," Shalev said in the release. "We hope that quantifying individuals' PTSD risk will be a first step toward systematic prevention of the disorder." – by Savannah Demko
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