172185 Natural course of PTSD symptoms among victims of violent crime

Wednesday, October 29, 2008: 12:30 PM

Martha Shumway, PhD , Department of Psychiatry, University of California, San Francisco, San Francisco, CA
George Jay Unick, PhD, MSW , Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Jennifer Alvidrez, PhD , Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Sharon Smart, MD, PhD , Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Gregory Merrill, MSW , School of Social Welfare, University of California, Berkeley, Berkeley, CA, CA
Vanessa Kelly, PsyD , Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Alicia Boccellari, PhD , Department of Psychiatry, University of California, San Francisco, San Francisco, CA
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.

Learning Objectives:
1. Recognize that victims of violent crime are at high risk for posttraumatic stress disorder (PTSD). 2. Recognize that victims of violent crime served in public sector settings may be at greater risk for PTSD than other crime victims. 3. Realize that specialized surveillance systems and intervention programs may be warranted for this population.

Keywords: Mental Health, Crime

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been conducting research on this topic for over 6 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Mental Health and Trauma
See more of: Mental Health