Predictors of undocumented PTSD in persons using public mental health services.

Individuals diagnosed with serious mental illness (SMI) have greater trauma exposure and are at increased risk for posttraumatic stress disorder (PTSD). However, PTSD is rarely documented in their clinical records. This study investigated the predictors of PTSD documentation among 776 clients with SMI receiving public mental health services, who had probable PTSD as indicated by a PTSD Checklist score of at least 45. Only 5.3% of clients had PTSD listed as a primary diagnosis, and 8.4% had PTSD as a secondary diagnosis, with a total 13.7% documentation rate. PTSD documentation rate was highest for clients with major depression (18.8%) compared to those with schizophrenia (4.1%) or bipolar disorder (6.3%). Factors that predicted a lower likelihood of having a chart diagnosis of PTSD included being diagnosed with schizophrenia/schizoaffective disorder or bipolar disorder. Factors that predicted a higher likelihood of having a chart diagnosis of PTSD included being of non-white race, being female, and experiencing eight or more types of traumatic events. Findings highlight the need for PTSD screening and trauma informed care for clients with SMI receiving public mental health services.

Intact perception of coherent motion, dynamic rigid form, and biological motion in chronic schizophrenia.

BACKGROUND: Prior studies have documented biological motion perception deficits in schizophrenia, but it remains unclear whether the impairments arise from poor social cognition, perceptual organization, basic motion processing, or sustained attention/motivation. To address the issue, we had 24 chronic schizophrenia patients and 27 healthy controls perform three tasks: coherent motion, where subjects indicated whether a cloud of dots drifted leftward or rightward; dynamic rigid form, where subjects determined the tilt direction of a translating, point-light rectangle; and biological motion, where subjects judged whether a human point-light figure walked leftward or rightward. Task difficulty was staircase controlled and depended on the directional variability of the background dot motion. Catch trials were added to verify task attentiveness and engagement. RESULTS: Patients and controls demonstrated similar performance thresholds and near-ceiling catch trial accuracy for each task (uncorrected ps > 0.1; ds < 0.35). In all but the coherent motion task, higher IQ correlated with better performance (ps < 0.001). CONCLUSION: Schizophrenia patients have intact perception of motion coherence, dynamic rigid form, and biological motion at least for our sample and set-up. We speculate that previously documented biological motion perception deficits arose from task or stimulus differences or from group differences in IQ, attention, or motivation.