Posttraumatic stress disorder in callers to the Anxiety Disorders Association of America

Abstract

We surveyed callers to the Anxiety Disorders Association of America (ADAA) with posttraumatic stress disorder (PTSD) and subthreshold PTSD (SPTSD). Most subjects heard about ADAA through media referrals and were satisfied with the service given by the association. The most frequent requests were for written information, learning how to cope with anxiety, and access to a local support group. Among callers, rates of PTSD (n ¼ 80) and SPTSD (n ¼ 111) were 8.0% and 11.1%, respectively. PTSD or SPTSD subjects were more likely to be younger, female, and with lower income than their no-Axis I psychiatric disorder controls (NAC) who had been exposed to trauma. In addition, they presented with more history of trauma, especially violent trauma, psychiatric comorbidity, recent psychotropic use, and side effects. More medical comorbidity, increased health service use, and reduced work productivity were also found among the PTSD and SPTSD subjects. SPTSD subjects were comparable to PTSD subjects on most of the measures with a few exceptions (more likely to be married, to have less psychiatric comorbidity, less medication use for mood and social fear, and fewer sedation and sexual side effects, and to have less health service use and work impairment). In conclusion, callers to ADAA with PTSD were particularly impaired and used the health care system extensively. Although the SPTSD subjects were not as impaired as those with PTSD, they were disadvantaged in many ways.

Examining PTSD treatment choice among individuals with subthreshold PTSD

“…Research has consistently shown that individuals with subthreshold PTSD experience significant distress and impairment (Mylle & Maes, 2004), which is at greater levels than trauma-exposed individuals without PTSD (Jakupcak et al, 2007), but less than individuals with full PTSD (Breslau et al, 2004). Individuals with subthreshold PTSD also report depressive symptoms (Cukor, Wyka, Jayasinghe, & Difede, 2010), suicidal ideation (Marshall et al, 2001), alcohol use (Adams, Boscarino, & Galea, 2006), anger and aggression (Jakupcak et al, 2007), impairment in social and family functioning (Stein et al, 1997; Zlotnick et al, 2002), work-loss days (Breslau et al, 2004), and medical illnesses (Zhang, Ross, & Davidson, 2004). Although some suggest that designating subthreshold PTSD as its own clinical concept pathologizes common reactions to trauma (e.g., Breslau et al, 2004), others support the concept of subthreshold PTSD as a means to potentially identify a crucial subpopulation that experiences significant psychopathology and functional impairment that persists (e.g., Jakupcak et al, 2007).…”

Obsessive-Compulsive Disorder in Callers to the Anxiety Disorders Association of America

“…NAC controls, however, had significantly less visits in the same time period. In comparison with other Axis I diagnosis from the ADAA survey, we found that OCD was associated with lower health service use than callers with post-traumatic stress disorder or social anxiety disorder (19,20).…”

“…3) to learn how to cope with anxiety problem (17,19, 15%); 4) to obtain the name of a professional in their area (14,15, 10%); and 5) to obtain information on medications (6, 5, 6%).…”

Symptom severity and lifetime and prospective health service use among military veterans evaluated for PTSD

“…Across studies, PTSD was a significant predictor of health care use [Elhai et al, 2005c]. Specifically, studies demonstrate that a PTSD diagnosis predicts a greater likelihood (and intensity) of MH [Boscarino et al, 2002;New and Berliner, 2000;Zhang et al, 2004] and medical services [Fagan et al, 2003;Zhang et al, 2004]. Three investigations also reveal that PTSD severity increases the likelihood of MH care use [Calhoun et al, 2002;Goto et al, 2002;Weine et al, 2000], whereas two studies fail to support this finding [Elhai et al, 2004;Schwarz and Kowalski, 1992].…”