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.

LanguageEnglish (US)
Pages117-129
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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