Abstract
The present study aimed to utilize a Receiver Operating Characteristic (ROC) approach in order to improve clinical decision-making for adolescents at risk for the development of psychopathology in the aftermath of a natural disaster. Specifically we assessed theoretically-driven individual, interpersonal, and event-related vulnerability factors to determine which indices were most accurate in forecasting PTSD. Furthermore, we aimed to translate these etiological findings by identifying clinical cut-off recommendations for relevant vulnerability factors. Our study consisted of structured phone-based clinical interviews with 2000 adolescent-parent dyads living within a 5-mile radius of tornados that devastated Joplin, MO, and northern Alabama in Spring 2011. Demographics, tornado incident characteristics, prior trauma, mental health, and family support and conflict were assessed. A subset of youth completed two behavioral assessment tasks online to assess distress tolerance and risk-taking behavior. ROC analyses indicated four variables that significantly improved PTSD diagnostic efficiency: Lifetime depression (AUC = .90), trauma history (AUC = .76), social support (AUC = .70), and family conflict (AUC = .72). Youth were 2–3 times more likely to have PTSD if they had elevated scores on any of these variables. Of note, event-related characteristics (e.g., property damage) were not related to PTSD diagnostic status. The present study adds to the literature by making specific recommendations for empirically-based, efficient disaster-related PTSD assessment for adolescents following a natural disaster. Implications for practice and future trauma-related developmental psychopathology research are discussed.
| Language | English (US) |
|---|---|
| Pages | 117-129 |
| Number of pages | 13 |
| Journal | Journal of Abnormal Child Psychology |
| Volume | 45 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2017 |
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Keywords
- Adolescents
- Evidence-based assessment
- PTSD risk assessment
- Stress disorders
- Traumatic stress
ASJC Scopus subject areas
- Developmental and Educational Psychology
- Psychiatry and Mental health
Cite this
Clinical Decision-Making Following Disasters : Efficient Identification of PTSD Risk in Adolescents. / Danielson, Carla Kmett; Cohen, Joseph Rich; Adams, Zachary W.; Youngstrom, Eric A.; Soltis, Kathryn; Amstadter, Ananda B.; Ruggiero, Kenneth J.
In: Journal of Abnormal Child Psychology, Vol. 45, No. 1, 01.01.2017, p. 117-129.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical Decision-Making Following Disasters
T2 - Journal of Abnormal Child Psychology
AU - Danielson, Carla Kmett
AU - Cohen, Joseph Rich
AU - Adams, Zachary W.
AU - Youngstrom, Eric A.
AU - Soltis, Kathryn
AU - Amstadter, Ananda B.
AU - Ruggiero, Kenneth J.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - The present study aimed to utilize a Receiver Operating Characteristic (ROC) approach in order to improve clinical decision-making for adolescents at risk for the development of psychopathology in the aftermath of a natural disaster. Specifically we assessed theoretically-driven individual, interpersonal, and event-related vulnerability factors to determine which indices were most accurate in forecasting PTSD. Furthermore, we aimed to translate these etiological findings by identifying clinical cut-off recommendations for relevant vulnerability factors. Our study consisted of structured phone-based clinical interviews with 2000 adolescent-parent dyads living within a 5-mile radius of tornados that devastated Joplin, MO, and northern Alabama in Spring 2011. Demographics, tornado incident characteristics, prior trauma, mental health, and family support and conflict were assessed. A subset of youth completed two behavioral assessment tasks online to assess distress tolerance and risk-taking behavior. ROC analyses indicated four variables that significantly improved PTSD diagnostic efficiency: Lifetime depression (AUC = .90), trauma history (AUC = .76), social support (AUC = .70), and family conflict (AUC = .72). Youth were 2–3 times more likely to have PTSD if they had elevated scores on any of these variables. Of note, event-related characteristics (e.g., property damage) were not related to PTSD diagnostic status. The present study adds to the literature by making specific recommendations for empirically-based, efficient disaster-related PTSD assessment for adolescents following a natural disaster. Implications for practice and future trauma-related developmental psychopathology research are discussed.
AB - The present study aimed to utilize a Receiver Operating Characteristic (ROC) approach in order to improve clinical decision-making for adolescents at risk for the development of psychopathology in the aftermath of a natural disaster. Specifically we assessed theoretically-driven individual, interpersonal, and event-related vulnerability factors to determine which indices were most accurate in forecasting PTSD. Furthermore, we aimed to translate these etiological findings by identifying clinical cut-off recommendations for relevant vulnerability factors. Our study consisted of structured phone-based clinical interviews with 2000 adolescent-parent dyads living within a 5-mile radius of tornados that devastated Joplin, MO, and northern Alabama in Spring 2011. Demographics, tornado incident characteristics, prior trauma, mental health, and family support and conflict were assessed. A subset of youth completed two behavioral assessment tasks online to assess distress tolerance and risk-taking behavior. ROC analyses indicated four variables that significantly improved PTSD diagnostic efficiency: Lifetime depression (AUC = .90), trauma history (AUC = .76), social support (AUC = .70), and family conflict (AUC = .72). Youth were 2–3 times more likely to have PTSD if they had elevated scores on any of these variables. Of note, event-related characteristics (e.g., property damage) were not related to PTSD diagnostic status. The present study adds to the literature by making specific recommendations for empirically-based, efficient disaster-related PTSD assessment for adolescents following a natural disaster. Implications for practice and future trauma-related developmental psychopathology research are discussed.
KW - Adolescents
KW - Evidence-based assessment
KW - PTSD risk assessment
KW - Stress disorders
KW - Traumatic stress
UR - http://www.scopus.com/inward/record.url?scp=84964370013&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84964370013&partnerID=8YFLogxK
U2 - 10.1007/s10802-016-0159-3
DO - 10.1007/s10802-016-0159-3
M3 - Article
VL - 45
SP - 117
EP - 129
JO - Journal of Abnormal Child Psychology
JF - Journal of Abnormal Child Psychology
SN - 0091-0627
IS - 1
ER -