Re-experiencing phenomena following a disaster: The long-term predictive role of intrusion symptoms in the development of post-trauma depression and anxiety

- Intrusion symptoms are highly prevalent in the absence of PTSD diagnosis.
- Intrusions are associated with concurrent affective and other anxiety disorders.
- Intrusions are predictive of increased rates of affective disorders 8 years later.

BackgroundContention in the literature regarding the diagnostic utility of intrusion symptoms highlights that they have high sensitivity but low specificity in predicting PTSD. They are highly prevalent following a range of traumatic events, and across a range of disorders. The prevalence of intrusion symptoms in the absence of PTSD suggests their relevance to the development of other psychopathology. Therefore, the predictive role of intrusion symptoms for other post-trauma psychopathology was examined using data from an epidemiological, longitudinal sample of adults recruited in childhood.MethodFrom 5 phases of data collection for this sample, these analyses focused on the 20 year and 28 year follow-ups (n=583). Lifetime exposure to trauma was assessed using a modified set of 10 Criterion-A events from the Composite International Diagnostic Interview (CIDI), with PTSD assessed in reference to a self-nominated worst lifetime event, and other DSM-IV disorder also assessed using the CIDI.ResultsResults showed that the presence of intrusion symptoms without PTSD at the 20 year follow-up was predictive of increased risk at 28 years for depressive but not anxiety disorders.LimitationsThere was limited psychopathology in the sample, reducing the power to examine many individual disorders. Furthermore, trauma history and psychiatric symptoms were retrospectively reported, introducing the possibility of recall bias.ConclusionTogether the findings suggest that intrusion symptoms may play an aetiological role in the development and/or maintenance of disorders other than PTSD.