
Am J Psychiatry 156:483-485, March 1999
©Copyright 1999 American Psychiatric Association
Assessing Long-Term Effects of Trauma: Diagnosing Symptoms of Avoidance and Numbing
Richard G. Honig, M.D.,
Mary C. Grace, M.Ed., M.S.,
Jacob D. Lindy, M.D.,
C. Janet Newman, M.D., and
James L. Titchener, M.D.
OBJECTIVE: This study compared the discovery of posttraumatic stress disorder (PTSD) symptoms by means of the Structured Clinical Interview for DSM-III-R (SCID) with a semistructured, psychodynamic clinical interview in a long-term follow-up of the survivors of the Buffalo Creek (W.Va.) flood. METHOD: Videotaped semistructured, psychodynamic clinical interviews of a small group of survivors (N=6) were compared with the results obtained in a prior group-level SCID investigation. RESULTS: Seventy-two percent of the total PTSD symptoms for the subjects studied were elicited exclusively by the psychodynamic clinical interview. PTSD cluster C symptoms of avoidance and numbing of general responsiveness were especially sensitive to discovery by this method. CONCLUSIONS: The psychodynamic clinical interview should be included in the design of studies that seek to investigate long-term effects of trauma, which are especially likely to be manifest in negative symptoms and subtle character change. (Am J Psychiatry 1999; 156:483485)
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