The Structure of Peritraumatic Reactions and Their Relationship With PTSD Among Disaster Survivors

Peritraumatic reactions such as fear, psychic and somatoform dissociation, tonic immobility, data-driven processing, and mental defeat are important in the etiology of posttraumatic stress disorder (PTSD). However, current measures of such reactions overlap conceptually and do not clearly identify distinct peritraumatic processes. It is not known which processes are uniquely associated with PTSD. We investigated the factor structure of six standard peritraumatic measures and their relationship with the four Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) PTSD symptom clusters. Measures were administered to 308 earthquake survivors with high levels of exposure to traumatic events. Items comprising the six measures were investigated using exploratory structural equation modeling, which identified five peritraumatic response factors. Items from most measures loaded on multiple factors. Mental defeat and somatoform dissociation significantly predicted all PTSD symptom clusters. Cognitive overload significantly predicted intrusions, avoidance, and alterations in arousal and reactivity. Immobility significantly predicted intrusions and avoidance, whereas distress significantly predicted negative alterations in cognition and mood and alterations in arousal and reactivity. Because of the key role such reactions play in the development of PTSD, the findings are likely to benefit the study of etiological mechanisms, the prediction of those at greatest risk, and the design of preventative interventions.

Automated summary

This study investigated the importance of peritraumatic reactions in the etiology of PTSD, finding that mental defeat and somatoform dissociation significantly predicted all PTSD symptom clusters. Other factors such as cognitive overload, immobility, and distress had varying effects on different symptom clusters. This research is likely to benefit the study of etiological mechanisms, risk prediction, and design of prevention interventions related to PTSD.