Research Article
What parts of PTSD are normal: Intrusion, avoidance, or arousal? Data from the Northridge, California, earthquake
J. Curtis McMillen,
Carol S. North,
Elizabeth M. Smith,
J. Curtis McMillen
Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University, St. Louis. Campus Box 1196, St. Louis, Missouri 63130
Search for more papers by this authorCarol S. North
Department of Psychiatry, School of Medicine, Washington University, St. Louis
Search for more papers by this authorElizabeth M. Smith
Department of Psychiatry, School of Medicine, Washington University, St. Louis
Dr. Smith died March 7, 1997.
Search for more papers by this authorJ. Curtis McMillen,
Carol S. North,
Elizabeth M. Smith,
J. Curtis McMillen
Center for Mental Health Services Research, George Warren Brown School of Social Work, Washington University, St. Louis. Campus Box 1196, St. Louis, Missouri 63130
Search for more papers by this authorCarol S. North
Department of Psychiatry, School of Medicine, Washington University, St. Louis
Search for more papers by this authorElizabeth M. Smith
Department of Psychiatry, School of Medicine, Washington University, St. Louis
Dr. Smith died March 7, 1997.
Search for more papers by this authorAbstract
The incidence and comorbidity of posttraumatic stress disorder (PTSD) are addressed in a study of 130 Northridge, California, earthquake survivors interviewed 3 months postdisaster. Only 13% of the sample met full PTSD criteria, but 48% met both the reexperiencing and the arousal symptom criteria, without meeting the avoidance and numbing symptom criterion. Psychiatric comorbidity was associated mostly with avoidance and numbing symptoms. For moderately severe traumatic events, reexperiencing and arousal symptoms may be the most “normal,” and survivors with a history of psychiatric problems may be those most likely to develop full PTSD. A system that considers people who meet all three symptom criteria to have a psychiatric disorder yet recognizes the distress of other symptomatic survivors may best serve traumatized populations.
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