Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;18(1):77-87.
doi: 10.1002/wps.20608.

Estimating the risk of PTSD in recent trauma survivors: results of the International Consortium to Predict PTSD (ICPP)

Arieh Y Shalev  1 , Martin Gevonden  2 , Andrew Ratanatharathorn  3 , Eugene Laska  1 , Willem F van der Mei  1 , Wei Qi  1 , Sarah Lowe  4 , Betty S Lai  5 , Richard A Bryant  6 , Douglas Delahanty  7 , Yutaka J Matsuoka  8 , Miranda Olff  9 , Ulrich Schnyder  10 , Soraya Seedat  11 , Terri A deRoon-Cassini  12 , Ronald C Kessler  13 , Karestan C Koenen  14 ; International Consortium to Predict PTSD
Collaborators, Affiliations

Estimating the risk of PTSD in recent trauma survivors: results of the International Consortium to Predict PTSD (ICPP)

Arieh Y Shalev et al. World Psychiatry. 2019 Feb.

Abstract

A timely determination of the risk of post-traumatic stress disorder (PTSD) is a prerequisite for efficient service delivery and prevention. We provide a risk estimate tool allowing a calculation of individuals' PTSD likelihood from early predictors. Members of the International Consortium to Predict PTSD (ICPP) shared individual participants' item-level data from ten longitudinal studies of civilian trauma survivors admitted to acute care centers in six countries. Eligible participants (N=2,473) completed an initial clinical assessment within 60 days of trauma exposure, and at least one follow-up assessment 4-15 months later. The Clinician-Administered PTSD Scale for DSM-IV (CAPS) evaluated PTSD symptom severity and diagnostic status at each assessment. Participants' education, prior lifetime trauma exposure, marital status and socio-economic status were assessed and harmonized across studies. The study's main outcome was the likelihood of a follow-up PTSD given early predictors. The prevalence of follow-up PTSD was 11.8% (9.2% for male participants and 16.4% for females). A logistic model using early PTSD symptom severity (initial CAPS total score) as a predictor produced remarkably accurate estimates of follow-up PTSD (predicted vs. raw probabilities: r=0.976). Adding respondents' female gender, lower education, and exposure to prior interpersonal trauma to the model yielded higher PTSD likelihood estimates, with similar model accuracy (predicted vs. raw probabilities: r=0.941). The current model could be adjusted for other traumatic circumstances and accommodate risk factors not captured by the ICPP (e.g., biological, social). In line with their use in general medicine, risk estimate models can inform clinical choices in psychiatry. It is hoped that quantifying individuals' PTSD risk will be a first step towards systematic prevention of the disorder.

Keywords: Post-traumatic stress disorder; clinician-administered PTSD scale for DSM-IV (CAPS); exposure to prior interpersonal trauma; female gender; lower education; prediction; prevention; risk assessment tool; trauma survivors.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Histogram of participants’ baseline PTSD symptoms severity scores (CAPS0 total scores). Dots represent individual participants; overlayed triangles those who subsequently developed PTSD. PTSD – post‐traumatic stress disorder, CAPS0 – baseline score on Clinician‐Administered PTSD Scale for DSM‐IV.
Figure 2
Figure 2
Predicted probabilities of endpoint PTSD conditional on initial (CAPS0) severity scores. The dots represent the raw conditional probability of PTSD at follow‐up given the CAPS0 score, smoothed with a kernel of width 5. The solid black line represents the logistic model predicted probability given the CAPS0 score. The gray area is the 95% confidence interval for the prediction model. The dashed line represents the prediction function derived from participants with follow‐up observations later than 9 months. PTSD – post‐traumatic stress disorder, CAPS0 – baseline score on Clinician‐Administered PTSD Scale for DSM‐IV.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Stein DJ, Karam EG, Shahly V et al. Post‐traumatic stress disorder associated with life‐threatening motor vehicle collisions in the WHO World Mental Health Surveys. BMC Psychiatry 2016;16:257. - PMC - PubMed
    1. Hoge CW, Castro CA, Messer SC et al. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med 2004;351:13‐22. - PubMed
    1. Kessler RC. Posttraumatic stress disorder: the burden to the individual and to society. J Clin Psychiatry 2000;61(Suppl. 5):4‐12. - PubMed
    1. Breslau N, Peterson E, Poisson L et al. Estimating post‐traumatic stress disorder in the community: lifetime perspective and the impact of typical traumatic events. Psychol Med 2004;34:889‐98. - PubMed
    1. Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress Disorder; Board on the Health of Select Populations; Institute of Medicine . Treatment for posttraumatic stress disorder in military and veteran populations: final assessment. Washington: Institute of Medicine National Research Council, 2014. - PubMed

LinkOut - more resources