The present article reports on the development and validation of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Diagnostic Scale (PTDS), that yields both a PTSD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994; DSM-IV} criteria and a measure of PTSD symptom severity. Twohundred forty-eight participants who had experienced a wide variety of traumas (e.g., accident, fire, natural disaster, assault, combat) were administered the PTSD module of the Structured Clinical Interview (SCID; Spitzer, Williams, Gibbons, & First, 1990), the PTDS, and scales measuring trauma-related psychopathology. The PTDS demonstrated high internal consistency and test-retest reliability, high diagnostic agreement with SCID, and good sensitivity and specificity. The satisfactory validity of the PTDS was further supported by its high correlations with other measures of traumarelated psychopathology. Therefore, the PTDS appears to be a useful tool for screening and assessing current PTSD in clinical and research settings.
This paper presents a coding system developed to explore changes in narratives of rape during therapy for posttraumatic stress disorder (PTSD) involving repeated reliving and recounting of the trauma. Relationships between narrative categories hypothesized to be affected by the treatment and treatment outcome were also examined. As hypothesized, narrative length increased from pre- to post-treatment, percentage of actions and dialogue decreased and percentage of thoughts and feelings increased, particularly thoughts reflecting attempts to organize the trauma memory. Also as expected, increase in organized thoughts was correlated negatively with depression. While indices of fragmentation did not significantly decrease during therapy, the hypothesized correlation between decrease in fragmentation and reduction in trauma-related symptoms was detected.
It has been proposed that persistent emotional disturbances following a highly distressing event indicate an inadequate processing of that event (Foa & Kozak, 1986;Rachman, 1980). Accordingly, chronic posttraumatic stress disorder (PTSD) indicates impaired processing of the trauma. Foa and Riggs (1993) proposed that traumatic memories are often disorganized and fragmented because they are encoded while the individual experiences extreme anxiety. The natural process of recovery from a trauma, they suggested, involves the organizing and streamlining of the memories. It follows that the memories of individuals who fail to recover from the trauma, and thus evidence chronic PTSD, will remain disjointed and that successful
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