Distinct correlates of post-traumatic stress disorder and subthreshold post-traumatic stress disorder considering a broad range of adverse experiences.
PTSD prevalence was 15.0% and subthreshold PTSD was 18.4% among trauma-exposed individuals, highlighting the importance of considering various trauma types in understanding PTSD symptoms.
Where it sits
this study against the rest of the eloralintide corpusSummary and findings
This study examined the prevalence and correlates of PTSD and subthreshold PTSD among 500 outpatients aged 21-65 with mood or schizophrenia spectrum disorders in Singapore. PTSD prevalence was reported at 15.0%, while subthreshold PTSD was at 18.4% among individuals with Criterion A events. The study highlights the importance of considering both Criterion A and non-Criterion A events in understanding PTSD symptoms.
Abstract
<b>Background:</b> While not all trauma-exposed individuals develop post-traumatic stress disorder (PTSD), many experience severe and enduring emotional effects. In Singapore, no study has investigated the prevalence and correlates of subthreshold PTSD and PTSD using gold-standard clinical interviews.<b>Objectives:</b> This study was the first to examine the prevalence and correlates of PTSD, subthreshold PTSD, and correlates associated while exploring a broad range of adverse experiences, including Criterion A (e.g. physical and sexual abuse) and non-Criterion A (e.g. emotional abuse) events.<b>Method:</b> We recruited 500 outpatients, aged 21-65, with mood or schizophrenia spectrum disorders from Singapore's only tertiary psychiatric hospital. Self-report measures assessed emotion dysregulation, suppression, and total trauma events. Clinical interviews, like the Clinician-Administered PTSD Scale (CAPS-5), measured dissociation and PTSD, while the Brief Psychiatric Rating Scale measured negative affect. Among trauma-exposed individuals (<i>n</i> = 461), multinomial regression examined differences between subthreshold PTSD, PTSD and the no-PTSD reference group, with analyses conducted separately for Criterion A and non-Criterion A events.<b>Results:</b> In the overall sample, PTSD prevalence was 15.0% and subthreshold PTSD was 18.4% among individuals with an index event classified as Criterion A. PTSD following an index event classified as Criterion A was associated with a broader range of correlates than index events classified as non-Criterion A. Conversely, among individuals exposed to events classified as non-Criterion A, PTSD was primarily associated with emotional correlates when subthreshold PTSD was defined as 'two of four criteria.' PTSD is also associated with a broader set of correlates than subthreshold PTSD across exposure types and subthreshold PTSD definitions. Correlates of subthreshold PTSD vary depending on exposure type. Negative affect was most frequently associated with multiple definitions of subthreshold PTSD and PTSD across trauma types.<b>Conclusion:</b> Findings suggest distinct symptom profiles by trauma type and emphasise the clinical relevance of non-Criterion A events and subthreshold PTSD.
Background
This paper addresses the prevalence and correlates of PTSD and subthreshold PTSD in trauma-exposed individuals, particularly in the context of a Singaporean psychiatric population. Prior research has established that not all trauma-exposed individuals develop PTSD, but there is limited understanding of subthreshold PTSD and its correlates. The study is significant as it utilizes gold-standard clinical interviews to explore a range of adverse experiences, contributing to the understanding of PTSD in diverse contexts.
Methods
The study employed a cross-sectional design with a sample of 500 outpatients aged 21-65 from Singapore's only tertiary psychiatric hospital. Participants were assessed using self-report measures for emotion dysregulation and total trauma events, alongside clinical interviews like the Clinician-Administered PTSD Scale (CAPS-5) for PTSD diagnosis. Multinomial regression was used to analyze differences between subthreshold PTSD, PTSD, and a no-PTSD reference group, with separate analyses for Criterion A and non-Criterion A events.
Results
In the overall sample, PTSD prevalence was 15.0% and subthreshold PTSD was 18.4% among individuals with Criterion A events. The study found that PTSD associated with Criterion A events had a broader range of correlates compared to those associated with non-Criterion A events. Negative affect was the most frequently reported correlate across multiple definitions of subthreshold PTSD and PTSD.
Interpretation
The findings suggest that PTSD and subthreshold PTSD have distinct symptom profiles based on the type of trauma experienced. Although the study provides valuable insights, the effect sizes and clinical significance of these findings require careful consideration. Limitations such as the specific population studied and potential biases from self-report measures may affect the generalizability of the results.
Key findings
- PTSD prevalence was 15.0% among trauma-exposed individuals, n=461.
- Subthreshold PTSD prevalence was 18.4% among trauma-exposed individuals with Criterion A events.
- PTSD following Criterion A events was associated with a broader range of correlates than non-Criterion A events.
- Negative affect was frequently associated with multiple definitions of subthreshold PTSD and PTSD across trauma types.
Limitations
- Focus on a specific population in Singapore limits generalizability.
- Reliance on self-report measures may introduce bias.
- Cross-sectional design does not establish causality.
- Small sample size for certain subgroup analyses.