TY - JOUR PY - 2016// TI - Clinical decision-making following disasters: efficient identification of PTSD risk in adolescents JO - Journal of abnormal child psychology A1 - Danielson, Carla Kmett A1 - Cohen, Joseph R. A1 - Adams, Zachary W. A1 - Youngstrom, Eric A. A1 - Soltis, Kathryn A1 - Amstadter, Ananda B. A1 - Ruggiero, Kenneth J. SP - 117 EP - 129 VL - 45 IS - 1 N2 - The present study aimed to utilize a Receiver Operating Characteristic (ROC) approach in order to improve clinical decision-making for adolescents at risk for the development of psychopathology in the aftermath of a natural disaster. Specifically we assessed theoretically-driven individual, interpersonal, and event-related vulnerability factors to determine which indices were most accurate in forecasting PTSD. Furthermore, we aimed to translate these etiological findings by identifying clinical cut-off recommendations for relevant vulnerability factors. Our study consisted of structured phone-based clinical interviews with 2000 adolescent-parent dyads living within a 5-mile radius of tornados that devastated Joplin, MO, and northern Alabama in Spring 2011. Demographics, tornado incident characteristics, prior trauma, mental health, and family support and conflict were assessed. A subset of youth completed two behavioral assessment tasks online to assess distress tolerance and risk-taking behavior. ROC analyses indicated four variables that significantly improved PTSD diagnostic efficiency: Lifetime depression (AUC = .90), trauma history (AUC = .76), social support (AUC = .70), and family conflict (AUC = .72). Youth were 2-3 times more likely to have PTSD if they had elevated scores on any of these variables. Of note, event-related characteristics (e.g., property damage) were not related to PTSD diagnostic status. The present study adds to the literature by making specific recommendations for empirically-based, efficient disaster-related PTSD assessment for adolescents following a natural disaster. Implications for practice and future trauma-related developmental psychopathology research are discussed.

Language: en

LA - en SN - 0091-0627 UR - http://dx.doi.org/10.1007/s10802-016-0159-3 ID - ref1 ER -