Natural course of PTSD symptoms among victims of violent crime

Objective: Following traumatic experiences, only a minority of adults develop posttraumatic stress disorder (PTSD). This study examined the natural course of PTSD symptoms among victims of violent crime, a group at elevated risk for PTSD. Methods: The sample comprises 204 crime victims recruited from an urban public hospital. PTSD symptoms (measured using the PTSD Checklist (PCL)) and other psychosocial and clinical characteristics were assessed following victimization and 4, 8 and 12 months later. Growth curve and latent profile transition analyses were used to characterize symptom course. Results: Participants' mean age was 38. 79% were male. 55% were Black; 17% were White; 11% were Latino. 43% were homeless. 45% had psychiatric diagnoses other than PTSD. A small, but statistically significant, decrease in PTSD symptoms was observed over time. However, mean PCL scores remained near 45, the cutpoint typically associated with PTSD diagnosis, at all assessments. Higher symptom scores were observed among participants who were Black or Latino, had other DSM diagnoses, and had more case management needs. 75% of participants had scores consistent with PTSD at some time during the study period. Only 10% showed improvement indicating remission of PTSD; 66% had PTSD after 12 months. Conclusions: Victims of violent crime served in public sector settings appeared to experience PTSD at higher rates than the 20% observed in other crime victim samples. Chronicity of symptoms was more common than natural recovery. Increased surveillance and early intervention appear warranted in this high-risk population.