Multivariate prediction of posttraumatic symptoms in psychiatric inpatients.

Based on a conceptual framework for the long-term effects of childhood abuse, this study examined the capacity of childhood family environment (caretaker dysfunction, neglect, perceived social support), violent abuse (physical and sexual), and individual variables (other abuse) to predict adult psychiatric symptoms of PTSD, dissociation, and depression. Complete interview data were obtained from 178 psychiatric in patients who varied greatly on abuse status and severity. Results of multiple regressions of predictor variables onto the three outcome variables showed that the predictor variables accounted for 15% (for depression) to 42% (for PTSD) of the variance in these symptoms and that violent abuse uniquely accounted for a significant proportion of the variance in outcomes for all three of the symptom groups studied.

Subtle presentations of post-traumatic stress disorder. Diagnostic issues.

The authors present a set of diagnostic procedures designed to detect subtle presentations of post-traumatic stress disorder (PTSD). Defined as a Type II diagnostic error (a false negative), the authors examine several sources of subtle presentations of PTSD. These include imperfect diagnostic instruments, high base rates, imperfect memory of critical events, imperfect reporting of signs and symptoms, imperfect interpretation of presented signs and symptoms, and diagnostic decisions based on informal clinical judgment. The authors believe that a multistage diagnostic procedure, using instruments with known psychometric properties while simultaneously looking for converging evidence is the best safeguard against missing an appropriate diagnosis of post-traumatic stress disorder.

The self as mediator in the psychopathology of female children of alcoholics.

Theoreticians long have argued for the centrality of strength or poverty of self-definitions in the prediction and understanding of psychopathology. In this research an empirical measure of strength of self-definition was developed based on the work of Hazel Markus. Consistency of self-description and resistance to challenge for this self-description were found to be related to reported alcoholism, trust, and life satisfaction/depression in children of alcoholics. In fact, nearly all variance in life satisfaction and alcoholism differentiating children of alcoholics (COA) from non-COA groups was controlled by the self variables. Clinical and theoretical implications of the significant findings were discussed.