Profiling posttraumatic functional impairment.

Many individuals who have been exposed to psychological trauma suffer from impaired functioning, regardless of whether they have PTSD. Our purpose was to identify a subset of PTSD symptoms linked to functional impairment to a) improve the likelihood that individuals with posttraumatic impairment receive treatment, and b) offer a method to assess cost-burden of trauma history in epidemiological studies. We examined patterns of trauma-related symptoms in two independent community surveys (N=1002 and 630). Rank ordering of symptoms and their associations with impairment guided construction of an impairment-related profile in the first data set. The profile was then tested in the second data set. The derived symptom profile, consisting of intense recollections and/or emotional symptoms upon exposure to reminders, plus one or more of numbing/detachment, avoidance, sleep problems, concentration problems, or hypervigilance, detected the majority (88% and 74%) of persons with posttraumatic functional impairment. The symptom profile can help identify traumatized individuals who may benefit from treatment but do not necessarily meet criteria for PTSD.