TY - JOUR
T1 - DSM-5 Criterion-A-Based Trauma Types in Service Members and Veterans Seeking Treatment for Posttraumatic Stress Disorder
AU - Benfer, Natasha
AU - Grunthal, Breanna
AU - Dondanville, Katherine A.
AU - Young-McCaughan, Stacey
AU - Blankenship, Abby
AU - Abdallah, Chadi G.
AU - Back, Sudie E.
AU - Flanagan, Julianne
AU - Foa, Edna B.
AU - Fox, Peter T.
AU - Krystal, John H.
AU - Marx, Brian P.
AU - McGeary, Donald D.
AU - McLean, Carmen P.
AU - Pruiksma, Kristi E.
AU - Resick, Patricia A.
AU - Roache, John D.
AU - Shiroma, Paulo
AU - Sloan, Denise M.
AU - Taylor, Daniel J.
AU - Wachen, Jennifer Schuster
AU - López-Roca, Argelio L.
AU - Nicholson, Karin L.
AU - Schobitz, Richard P.
AU - Schrader, Christian C.
AU - Sharrieff, Allah Fard M.
AU - Yarvis, Jeffrey S.
AU - Mintz, Jim
AU - Keane, Terence M.
AU - Peterson, Alan L.
AU - Litz, Brett T.
N1 - Publisher Copyright:
© (2023), (American Psychological Association). All Rights Reserved.
PY - 2023/7/6
Y1 - 2023/7/6
N2 - Objective: In posttraumatic stress disorder (PTSD), the assumption of the equipotentiality of traumas ignores potentially unique contexts and consequences of different traumas. Accordingly, Stein et al. (2012) developed a reliable typing scheme in which assessors categorized descriptions of traumatic events into six “types”: life threat to self (LTS), life threat to other, aftermath of violence (AV), traumatic loss, moral injury by self (MIS), and moral injury by other (MIO). We extended this research by validating the typing scheme using participant endorsements of type, rather than assesor-based types. We examined the concordance of participant and assesor types, frequency, and validity of participant-based trauma types by examining associations with baseline mental and behavioral health problems. Method: Interviewers enrolled military personnel and veterans (N = 1,443) in clinical trials of PTSD and helped them select the most currently distressing Criterion-A trauma. Participants and, archivally, assessors typed the distressing aspect(s) of this experience. Results: AV was the most frequently participant-endorsed type, but LTS was the most frequently rated worst part of an event. Although participants endorsed MIS and MIO the least frequently, these were associated with worse mental and behavioral health problems. The agreement between participants and assessors regarding the worst part of the event was poor. Conclusion: Because of discrepancies between participant and assessor typologies, clinical researchers should use participants’ ratings, and these should trump assessor judgment. Differences in pretreatment behavioral and mental health problems across some participant-endorsed trauma types partially support the validity of the participant ratings.
AB - Objective: In posttraumatic stress disorder (PTSD), the assumption of the equipotentiality of traumas ignores potentially unique contexts and consequences of different traumas. Accordingly, Stein et al. (2012) developed a reliable typing scheme in which assessors categorized descriptions of traumatic events into six “types”: life threat to self (LTS), life threat to other, aftermath of violence (AV), traumatic loss, moral injury by self (MIS), and moral injury by other (MIO). We extended this research by validating the typing scheme using participant endorsements of type, rather than assesor-based types. We examined the concordance of participant and assesor types, frequency, and validity of participant-based trauma types by examining associations with baseline mental and behavioral health problems. Method: Interviewers enrolled military personnel and veterans (N = 1,443) in clinical trials of PTSD and helped them select the most currently distressing Criterion-A trauma. Participants and, archivally, assessors typed the distressing aspect(s) of this experience. Results: AV was the most frequently participant-endorsed type, but LTS was the most frequently rated worst part of an event. Although participants endorsed MIS and MIO the least frequently, these were associated with worse mental and behavioral health problems. The agreement between participants and assessors regarding the worst part of the event was poor. Conclusion: Because of discrepancies between participant and assessor typologies, clinical researchers should use participants’ ratings, and these should trump assessor judgment. Differences in pretreatment behavioral and mental health problems across some participant-endorsed trauma types partially support the validity of the participant ratings.
KW - Criterion-A
KW - military personnel
KW - moral injury
KW - posttraumatic stress disorder
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=85170256175&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85170256175&partnerID=8YFLogxK
U2 - 10.1037/tra0001537
DO - 10.1037/tra0001537
M3 - Article
C2 - 37410416
AN - SCOPUS:85170256175
SN - 1942-9681
VL - 16
SP - 1218
EP - 1228
JO - Psychological Trauma: Theory, Research, Practice, and Policy
JF - Psychological Trauma: Theory, Research, Practice, and Policy
IS - 7
ER -