DIAGNOSTIC EFFICACY OF POSTTRAUMATIC SYMPTOMS IN CHILDREN EXPOSED TO DISASTER

Examined 5 conditional probability indices to determine the diagnostic efficacy of 48 symptoms associated with posttraumatic stress disorder (PTSD) in 5,687 children exposed to Hurricane Hugo, of whom 5.5% had a diagnosis of posttraumatic stress syndrome (PTSS). Moderate levels o f sensitivity and high levels of specificity were obtained for most sy mptoms. Odds ratios more precisely demonstrated that some Diagnostic a nd Statistical Manual of Mental Disorders (DSM) symptoms of PTSD, espe cially when combined were useful for identifying children with PTSS bu t that anxiety symptoms and some DSM symptoms of PTSD had poor diagnos tic utility. Satisfying criteria for the DSM-III-R numbing/avoidance c luster and symptoms from the numbing/avoidance cluster had the highest diagnostic efficacy, suggesting that avoidance may be the hallmark of severe posttraumatic reactions. These results suggest which symptoms should be conceptualized as central versus peripheral to the disorder and which symptoms and symptom combinations clinicians should attend t o most when diagnosing or screening PTSD in children.