Health-related quality of life in posttraumatic stress disorder: 4 years follow-up study of individuals exposed to urban violence.

Evidence suggests that Posttraumatic Stress Disorder (PTSD) is associated with substantially reduced Health-related quality of life (HRQoL). This study aimed to explore the impact of PTSD symptoms in HRQoL and its predictors in individuals exposed to urban violence. We follow-up a cohort of 267 individuals exposed to urban violence, derived from an epidemiological survey and clinical cases from an outpatient program of victims of violence, with and without PTSD, by assessing symptoms and other measures at two intervals, approximately 4 years apart. PTSD symptom severity was associated with poorer quality of life at baseline and at follow-up. Higher levels of depression and anxiety, new trauma experiences, more traumas in childhood and more PTSD arousal symptoms were all predictors of lower HRQoL over time. Results strongly suggest the need to assess HRQoL in addition to symptoms in order to assess the true severity of PTSD. These results have implications for the functional recovery in the treatment of PTSD.

The accuracy of the Clinician-Administered PTSD Scale (CAPS) to identify PTSD cases in victims of urban violence.

As a consequence of the increasing urban violence in Brazil, many cases of posttraumatic stress disorder (PTSD) are now seen in the community and clinical settings. The main aim of this article is to assess the psychometric properties of the Clinician-Administered PTSD Scale (CAPS) to study factors related to the etiology, prognosis, and efficacy of interventions of PTSD in civilian populations. PTSD outpatients from a program of victims of violence and subjects identified in an epidemiological survey conducted in the city of Sao Paulo completed a battery of validated instruments and the CAPS. Instrument reliability and validity were measured. The comparison between the CAPS scores and the Structured Clinical Interview for DSM IV (SCID) interview resulted in the following validity coefficients: sensitivity=90%, specificity=95%, and misclassification rate=7.1%. The area under the receiver operating characteristic (ROC) curve was 0.97. There was a positive correlation between CAPS scores with Beck Depression Inventory (BDI; 0.70) and Beck Anxiety Inventory (BAI; 0.76) scores. The Kappa coefficients were all higher than 0.63 for all CAPS items. The internal consistency for all CAPS items resulted in a Cronbach's alpha coefficient of 0.97. The CAPS showed to be both an accurate and a reliable research instrument to identify PTSD cases in a civilian population.

Terapia Interpessoal: teoria, formação e prática clínica em um serviço de pesquisa e atendimento em violência / Interpersonal Therapy: theory, training and clinical practice in a search service and care in violence

A psicoterapia interpessoal (TIP) é uma terapia estruturada breve e focal desenvolvidainicialmente para o tratamento da depressão. Esse modelopsicoterápico foi adaptado para outros transtornos mentais, incluindo transtornodo estresse pós-traumático. O programa de atendimento e pesquisaem violência (PROVE) é um ambulatório ligado à Universidade Federal de SãoPaulo (UNIFESP) que presta assistência a vítimas de violência. A terapiainterpessoal individual e de grupo é umas das formas de atendimento psicológicoutilizado no PROVE. Um curso de formação anual é realizado com oobjetivo de produção de conhecimento e pesquisa em TIP.(AU)

Terapia interpessoal: teoria, formação e prática clínica em um serviço de pesquisa e atendimento em violência / Interpersonal therapy: theory, training and clinical practice in a search service and care in violence

A psicoterapia interpessoal (TIP) é uma terapia estruturada breve e focal desenvolvidainicialmente para o tratamento da depressão. Esse modelopsicoterápico foi adaptado para outros transtornos mentais, incluindo transtornodo estresse pós-traumático. O programa de atendimento e pesquisaem violência (PROVE) é um ambulatório ligado à Universidade Federal de SãoPaulo (UNIFESP) que presta assistência a vítimas de violência. A terapiainterpessoal individual e de grupo é umas das formas de atendimento psicológicoutilizado no PROVE. Um curso de formação anual é realizado com oobjetivo de produção de conhecimento e pesquisa em TIP.

[Early Trauma Inventory (ETI): cross-cultural adaptation and internal consistency]. / Adaptação transcultural e consistência interna do Early Trauma Inventory (ETI).

Early life stress is a strong predictor of future psychopathology during adulthood. The Early Trauma Inventory (ETI) was developed to detect the presence and impact of traumatic experiences that occurred up to 18 years of age. The ETI was translated and cross-culturally adapted and had its consistency evaluated. Victims of violence that met the inclusion and exclusion criteria were submitted to SCID-I and ETI. Ninety-one patients with post-traumatic stress disorder (PTSD) were included. Cronbach's alpha in the different domains varied from 0.595 to 0.793, and the total score was 0.878. Except for emotional abuse, most of the various domains displayed inter-item correlation rates of 0.51 to 0.99. The adapted version was useful for clinical and research purposes and showed good internal consistency and inter-item correlation. The ETI is a valid instrument with good consistency for evaluating history of childhood and adolescent trauma in adults.

Adaptação transcultural e consistência interna do Early Trauma Inventory (ETI) / Early Trauma Inventory (ETI): cross-cultural adaptation and internal consistency

As experiências traumáticas precoces são um fator de risco preditivo de problemas psicopatológicos futuros. O Early Trauma Inventory (ETI) é um instrumento que avalia em indivíduos adultos experiências traumáticas ocorridas antes dos 18 anos de idade. Tal instrumento foi traduzido, transculturalmente adaptado e sua consistência interna foi avaliada. Vítimas de violência que preencheram os critérios de inclusão e exclusão foram submetidas a uma entrevista diagnóstica (SCID-I) e ao ETI. Foram incluídos 91 pacientes com o transtorno do estresse pós-traumático (TEPT). O alfa de Cronbach nos diferentes domínios variou de 0,595-0,793, e o escore total foi de 0,878. A maior parte dos itens nos vários domínios, com exceção do abuso emocional, apresentou índices de correlação interitem entre 0,51-0,99. A versão adaptada foi útil tanto na clínica quanto na pesquisa. Apresentou boa consistência interna e na correlação interitem. O ETI é um instrumento válido, com boa consistência para se avaliar a presença de história de traumas precoces em indivíduos adultos.

Early life stress is a strong predictor of future psychopathology during adulthood. The Early Trauma Inventory (ETI) was developed to detect the presence and impact of traumatic experiences that occurred up to 18 years of age. The ETI was translated and cross-culturally adapted and had its consistency evaluated. Victims of violence that met the inclusion and exclusion criteria were submitted to SCID-I and ETI. Ninety-one patients with post-traumatic stress disorder (PTSD) were included. Cronbach's alpha in the different domains varied from 0.595 to 0.793, and the total score was 0.878. Except for emotional abuse, most of the various domains displayed inter-item correlation rates of 0.51 to 0.99. The adapted version was useful for clinical and research purposes and showed good internal consistency and inter-item correlation. The ETI is a valid instrument with good consistency for evaluating history of childhood and adolescent trauma in adults.