A Comparison of Dimensional and Categorical Approaches to Characterizing the Association Between Posttraumatic Stress Disorder and Future Suicide Attempts. Issue 6 (21st May 2021)

• Record Type: Journal Article
• Authors: Lee, Daniel J.; Kearns, Jaclyn C.; Stanley, Ian H.; Spitzer, Elizabeth G.; Woodward, Bonnie; Keane, Terence M.; Marx, Brian P.
• Other Names: Kerig Patricia K. guestEditor.
• Is Part Of: Journal of traumatic stress. Volume 34:Issue 6(2021)
• Page Start: 1099
• Page End: 1107
• Publication Date: 2021-05-21
• Subjects: Post-traumatic stress disorder -- Periodicals; 616.8521
• DOI: 10.1002/jts.22689
• Languages: English
• ISSNs: 0894-9867

Abstract

Abstract: The present study compared the utility of categorical (i.e., diagnostic status) and dimensional (i.e., symptom severity) approaches to measuring posttraumatic stress disorder (PTSD) in predicting future suicide attempts among participants in a nationwide, longitudinal study of U.S. military veterans who were deployed in support of operations in Iraq or Afghanistan after the September 11, 2001, terrorist attacks (9/11) and were enrolled in Veterans Health Administration services ( N = 1, 649). Following an initial assessment of PTSD symptoms, we assessed for suicide attempts at two subsequent time points ( M = 28.74 months, SD = 8.72 and M = 55.11 months, SD = 6.89 following the initial assessment). Between the initial and final assessments, 125 participants (7.58%) made at least one suicide attempt. All categorical and dimensional indicators of PTSD predicted suicide attempts at both time points except the categorical indicator for reexperiencing symptoms. Categorical indicators predicting suicide attempts demonstrated excellent sensitivity but poor specificity and overall accuracy. The point along the continuum at which PTSD symptom severity was most accurate regarding the prediction of future suicide attempts was well above the threshold previously established as indicating a probable diagnosis. Although this score was less sensitive than diagnostic indicators, it demonstrated greater specificity and overall accuracy in predicting future suicide attempts. The present results indicate that veterans whose PTSD symptoms satisfy the diagnostic criteria have a higher risk of future suicide attempts, but this risk appears to be even higher for veterans with symptom levels above the diagnostic threshold. 抽象: Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Traditional Chinese 創傷後壓力症與未來自殺企圖之間關係的維度及分類方法的比較 摘要 本研究比較了分類(即診斷狀態)及維度(即症狀嚴重程度)測量創傷後壓力症(PTSD)的方法在預測未來自殺企圖方面的效用, 對2001年9月11日恐怖襲擊(9/11)後被部署到伊拉克或阿富汗支持行動的美國退伍軍人進行縱向研究, 並登記在退伍軍人健康管理服務(N = 1649)。在對創傷後壓力症症狀進行初步評估後, 我們在隨後的兩個時間點對自殺企圖進行了評估(初步評估後, M=28.74個月, SD=8.72;M=55.11個月, SD=6.89)。在最初及最後的評估之間, 125名參與者(7.58%)至少有一次自殺企圖。除了重新體驗症狀的分類指標外, PTSD的所有分類及維度指標在兩個時間點都預測了自殺企圖。預測自殺未遂的分類指標顯示出極好的敏感性, 但特異性及總體準確性較差。創傷後壓力症症狀嚴重程度在預測未來自殺企圖方面最準確的連續點, 遠遠高於以前確定的表明可能診斷的閾值。儘管這個分數不如診斷指標敏感, 但它在預測未來自殺企圖方面表現出更大的特異性及總體準確性。本研究結果表明, PTSD症狀符合診斷標準的退伍軍人未來有較高的自殺企圖風險, 但症狀水平高於診斷閾值的退伍軍人的自殺企圖風險似乎更高。 Simplified Chinese 创伤后压力症与未来自杀企图之间关系的维度及分类方法的比较 摘要 本研究比较了分类(即诊断状态)及维度(即症状严重程度)测量创伤后压力症(PTSD)的方法在预测未来自杀企图方面的效用, 对2001年9月11日恐怖袭击(9/11)后被部署到伊拉克或阿富汗支持行动的美国退伍军人进行纵向研究, 并登记在退伍军人健康管理服务(N = 1649)。在对创伤后压力症症状进行初步评估后, 我们在随后的两个时间点对自杀企图进行了评估(初步评估后, M=28.74个月, SD=8.72;M=55.11个月, SD=6.89)。在最初及最后的评估之间, 125名参与者(7.58%)至少有一次自杀企图。除了重新体验症状的分类指标外, PTSD的所有分类及维度指标在两个时间点都预测了自杀企图。预测自杀未遂的分类指针显示出极好的敏感性, 但特异性及总体准确性较差。创伤后压力症症状严重程度在预测未来自杀企图方面最准确的连续点, 远远高于以前确定的表明可能诊断的阈值。尽管这个分数不如诊断指针敏感, 但它在预测未来自杀企图方面表现出更大的特异性及总体准确性。本研究结果表明, PTSD症状符合诊断标准的退伍军人未来有较高的自杀企图风险, 但症状水平高于诊断阈值的退伍军人的自杀企图风险似乎更高。