Clinical Decision-Making Following Disasters

Efficient Identification of PTSD Risk in Adolescents

Carla Kmett Danielson, Joseph Rich Cohen, Zachary W. Adams, Eric A. Youngstrom, Kathryn Soltis, Ananda B. Amstadter, Kenneth J. Ruggiero

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)117-129
Number of pages13
JournalJournal of Abnormal Child Psychology
Volume45
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Disasters
Post-Traumatic Stress Disorders
Area Under Curve
Tornadoes
Family Conflict
Psychopathology
ROC Curve
Wounds and Injuries
Risk-Taking
Social Support
Mental Health
Demography
Clinical Decision-Making
Interviews
Depression
Research

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

Danielson, C. K., Cohen, J. R., Adams, Z. W., Youngstrom, E. A., Soltis, K., Amstadter, A. B., & Ruggiero, K. J. (2017). Clinical Decision-Making Following Disasters: Efficient Identification of PTSD Risk in Adolescents. Journal of Abnormal Child Psychology, 45(1), 117-129. https://doi.org/10.1007/s10802-016-0159-3

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 journalArticle

Danielson, Carla Kmett ; Cohen, Joseph Rich ; Adams, Zachary W. ; Youngstrom, Eric A. ; Soltis, Kathryn ; Amstadter, Ananda B. ; Ruggiero, Kenneth J. / Clinical Decision-Making Following Disasters : Efficient Identification of PTSD Risk in Adolescents. In: Journal of Abnormal Child Psychology. 2017 ; Vol. 45, No. 1. pp. 117-129.
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