Posttraumatic stress symptom clusters associations with psychopathology and functional impairment

We examined posttraumatic stress symptom clusters associations with psychopathology and functional impairment in 899 Norwegian survivors of the 2004 South-East Asia tsunami six months post-disaster. Posttraumatic stress symptoms were assessed with the Impact of Event Scale-Revised (IES-R) with intrusion, avoidance, and hyper-arousal subscales. For criterion variables, we used 10 indicators of psychopathology and functional impairment, e.g. having mental health problems, seeing mental health professionals, and use of medication or sick leave. Hyper-arousal had stronger correlations than avoidance with all criterion variables (p values < 0.001) and stronger correlations than intrusion with seven of the 10 criterion variables (p values < 0.01). Also, intrusion had stronger correlations than avoidance with seven of 10 criterion variables (p values < 0.05). Thus, our findings indicate that symptoms of hyper-arousal may be more closely linked to psychopathology and functional impairment than other symptoms of posttraumatic stress following a sudden onset, short duration, natural disaster event.

Research highlights▶ Functional impairment in disaster victims is related to PTSD symptoms. ▶ Hyper-arousal may account for more of the impairment than intrusion and avoidance/numbing. ▶ Previous findings of the relative importance of avoidance/numbing symptoms may be overstated. ▶ In DSM-V more diagnostic weight should be put on the hyper-arousal symptom cluster.