ABSTRACT
This study examined the relation between posttraumatic stress disorder (PTSD) and suicidal ideation among U.S. military veterans deployed during Operation Enduring Freedom and/or Operation Iraqi Freedom. Specific aims included investigation of (1) whether PTSD was associated with suicidal ideation after controlling for combat exposure and history of suicide attempt(s), (2) whether PTSD was associated with suicidal ideation absent a co-occurring depressive disorder (MDD) or alcohol use disorder (AUD), (3) whether co-occurring MDD or AUD increased risk of suicidal ideation among those with PTSD and (4) whether PTSD/MDD symptom clusters were differentially associated with suicidal ideation. Results pointed to unique effects associated with prior suicide attempt(s), PTSD and MDD. PTSD-diagnosed participants with co-occurring MDD or AUD were not significantly more likely to endorse suicidal ideation than PTSD-diagnosed participants without such comorbidity. The 'emotional numbing' cluster of PTSD symptoms and the 'cognitive-affective' cluster of MDD symptoms were uniquely associated with suicidal ideation.
Subject(s)
Stress Disorders, Post-Traumatic/psychology , Suicidal Ideation , Suicide, Attempted/psychology , Veterans/psychology , Adult , Afghan Campaign 2001- , Aged , Depression/diagnosis , Depression/psychology , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Female , Health Surveys , Humans , Iraq War, 2003-2011 , Logistic Models , Male , Middle Aged , Psychiatric Status Rating Scales , Risk , Stress Disorders, Post-Traumatic/diagnosisABSTRACT
Posttraumatic stress disorder (PTSD) is a prevalent anxiety disorder that is often undetected among primary care patients. The Department of Veterans Affairs has implemented the Primary Care-PTSD Screen (PC-PTSD) to screen for PTSD; however, minimal research has examined its utility. This study was designed to assess the diagnostic accuracy of the PC-PTSD among veterans who had served since 9/11/2001, including operations in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom). Signal detection analyses were used to evaluate the performance of the PC-PTSD and two other screens, the Davidson Trauma Scale (DTS) and the SPAN, in a sample of 220 veterans with military service since 9/11/2001. The reference standard for PTSD was Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) diagnosis based upon structured clinical interview. The impact of demographic variables on test performance was examined. A cutting score of 3 on the PC-PTSD maximized efficiency (85%; sensitivity=0.83; and specificity=0.85). Although analyses supported the utility of the PC-PTSD (area under the curve (AUC)=0.875), the measure was outperformed by both the DTS (AUC=0.944) and the SPAN (AUC=0.931). Results suggest that the PC-PTSD is an acceptable screen for PTSD among veterans. Within primary care settings, the PC-PTSD may be most advantageously employed in the context of staged screening, given the measure's relative susceptibility to false positives.
Subject(s)
Combat Disorders/diagnosis , Primary Health Care/methods , Primary Health Care/statistics & numerical data , Stress Disorders, Post-Traumatic/diagnosis , Veterans , Adult , Disability Evaluation , Female , Humans , Male , Middle Aged , ROC Curve , Reference Values , Severity of Illness Index , Surveys and Questionnaires , United StatesABSTRACT
This study investigated whether the perception of self as socially rejected might contribute to increased physical aggression among elementary-school children. It was hypothesized that physically aggressive children would become more physically aggressive over time if they perceived that they were rejected and tended to blame peers for social failure experiences. Third-grade boys and girls (n = 941) were assessed in the Fall and Spring of the school year. Peer-report data on physical aggression and social preference were collected, along with self-report data on perceived rejection and attributions for social failure experiences. Results for boys were consistent with hypotheses, whereas the results for girls revealed a different pattern of relations. These results constitute prospective evidence that children's self-perceptions of social rejection can uniquely influence externalizing behavior. Results are discussed in terms of mechanisms that might mediate the relation between perceived rejection and physical aggression.
