Citation

Litz BT, Contractor AA, Rhodes C, Dondanville KA, Jordan AH, Resick PA, Foa EB, Young-McCaughan S, Mintz J, Yarvis JS, Peterson AL. J. Trauma. Stress 2018; 31(2): 286-295.

Affiliation

Research and Development Service, South Texas Veterans Health Care System, San Antonio, Texas, USA.

Copyright

(Copyright © 2018, International Society for Traumatic Stress Studies, Publisher John Wiley and Sons)

DOI

10.1002/jts.22276

PMID

29669185

Abstract

We examined the frequency of trauma types reported in a cohort of service members seeking treatment for posttraumatic stress disorder (PTSD) and compared symptom profiles between types. In this observational study, 999 service members (9.2% women; M_age = 32.91 years; 55.6% White) were evaluated using a standardized assessment procedure to determine eligibility for clinical trials. Participants were evaluated for DSM-IV-TR-defined PTSD using the PTSD Symptom Scale-Interview; all participants reported a Criterion A event. Independent evaluators rated descriptions of Criterion A events as belonging to trauma types at a high degree of reliability, κ = 0.80. Aggregated non-life-threat primary trauma types were more frequently endorsed than aggregated life-threat types, 95% CI [17.10%, 29.20%]. Participants who endorsed moral injury-self traumas had a higher level of reexperiencing (d = 0.39), guilt (hindsight bias, d = 1.06; wrongdoing, d = 0.93), and self-blame (d = 0.58) symptoms, relative to those who reported life threat-self. Participants who experienced traumatic loss had greater reexperiencing (d = 0.39), avoidance (d = 0.22), guilt (responsibility, d = 0.39), and greater peri- and posttraumatic sadness (d = 0.84 and d = 0.70, respectively) symptoms, relative to those who endorsed life threat-self. Relative to life threat-self, moral injury-others was associated with greater peri- (d = 0.36) and posttraumatic (d = 0.33) betrayal/humiliation symptoms, and endorsement of aftermath of violence was associated with greater peri- (d = 0.84) and posttraumatic sadness (d = 0.57) symptoms. War zone traumas were heterogeneous, and non-life-threat traumas were associated with distinct symptoms and problems.

Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Language: en