Reactivation of posttraumatic stress in male disaster survivors: The role of residual symptoms

The aim of this study was to establish the relative distribution of resilient, remitted, chronic and reactivated posttraumatic stress disorder (PTSD) in a population of survivors from a major civilian disaster. Residual PTSD symptoms were explored to identify predictors of future reactivation. Symptoms were measured by the Impact of Event Scale (IES) 5.5 months, 14 months and 5 years after the disaster. Forty-eight survivors (79%) were interviewed after 27 years. PTSD status was determined by using the Structural Clinical Interview for DSM-IV axis I Disorders (SCID-I). The distributions were: 58.3% resilient, 14.6% remitted, 8.3% chronic, and 18.8% reactivated PTSD. Number of residual symptoms from intrusion and avoidance 14 months and 5 years past trauma predicted later reactivation. Intrusion symptoms in general, and sleep related intrusions in particular, were the most consistent predictors deserving special attention. (C) 2010 Elsevier Ltd. All rights reserved.