Assessing Long-Term Effects of Trauma: Diagnosing Symptoms of Avoidance and Numbing

• Published in: The American journal of psychiatry Vol. 156; no. 3; pp. 483 - 485
• Main Authors: Honig, Richard G., Grace, Mary C., Lindy, Jacob D., Newman, C. Janet, Titchener, James L.
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Publishing 01-03-1999; American Psychiatric Association
• Subjects: Adult; Adult and adolescent clinical studies; Anxiety disorders. Neuroses; Biological and medical sciences; Child; Defence mechanisms; Disasters; Factors; Floods; Follow-Up Studies; Humans; Life Change Events; Longitudinal studies; Medical sciences; Post traumatic stress disorder; Psychiatric Status Rating Scales - statistics & numerical data; Psychiatry; Psychological tests; Psychological trauma; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychopathology. Psychiatry; Research Design; Stress Disorders, Post-Traumatic - diagnosis; Stress Disorders, Post-Traumatic - psychology; Survivors; Survivors - psychology; Videotape Recording; Buffalo Creek West Virginia; United States > US; Human; Posttraumatic syndrome; Anxiety disorder; Psychometrics; Disaster; Psychological effect; Long term; Stress; Symptomatology; Flood; Follow up study; Clinical interview; Diagnosis
• ISSN: 0002-953X; 1535-7228
• DOI: 10.1176/ajp.156.3.483

OBJECTIVE: This study compared the discovery of posttraumatic stress disorder (PTSD) symptoms by means of the Structured Clinical Interview for DSM-III-R (SCID) with a semistructured, psychodynamic clinical interview in a long-term follow-up of the survivors of the Buffalo Creek (W.Va.) flood. METHOD: Videotaped semistructured, psychodynamic clinical interviews of a small group of survivors (N=6) were compared with the results obtained in a prior group-level SCID investigation. RESULTS: Seventy-two percent of the total PTSD symptoms for the subjects studied were elicited exclusively by the psychodynamic clinical interview. PTSD cluster C symptoms of avoidance and numbing of general responsiveness were especially sensitive to discovery by this method. CONCLUSIONS: The psychodynamic clinical interview should be included in the design of studies that seek to investigate long-term effects of trauma, which are especially likely to be manifest in negative symptoms and subtle character change. (Am J Psychiatry 1999; 156:483-485)