Posttraumatic stress disorder (PTSD)
LASA091 / LASA291
Contact: Almar Kok
Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may develop after a person is exposed to one or more traumatic events, such as sexual abuse, war trauma, serious injury, or threats of imminent death. PTSD may develop immediate after the traumatic even, but sometimes it emerges many years later. The diagnosis is based on a group of symptoms, such as recurring flashbacks, avoidance or numbing of memories of the event, sleep problems and psychological suffering. The lifetime prevalence of PTSD is 1.0–9.2% (Hidalgo et al. 2000). Few studies examined the prevalence of PTSD in older adults. In the LASA sample the 6-month prevalence of PTSD and of subthreshold PTSD was 0.9 and 13.1%, respectively. The strongest vulnerability factors for both PTSD and subthreshold PTSD were neuroticism and adverse events in early childhood (Van Zelst 2003a).
Measurement instruments in LASA
The self-rating inventory for posttraumatic stress disorder (SRIP) is developed in 1994 by Hovens and colleagues. It registers symptoms of PTSD, but does not assess trauma. As such, the SRIP is more appropriate as a screening device than as a diagnostic instrument. The SRIP is a 22-item scale based on DSM-IV-criteria. Symptoms must be present in the last 4 weeks before the interview. The SRIP total scores range from 22 to 88 points, counting the ratings on each question on a 4-point scale (1 = not at all, 4 = extremely). The advised threshold for caseness is 52 points. Normative figures for the SRIP were published for a population consisting of 7083 Dutch persons (Hovens et al., 2000). Normative scores for the older adults were based on a sample of 1461 subjects (Bramsen, 1995). Van Zelst et al. studied the criterion validity of the SRIP. She showed that at a cut-off of 52, the (weighted) sensitivity was 22.6% and the specificity was 97.7%; the positive predictive value was 17.1% and the negative predictive value was 98.4%. (Van Zelst et al. 2003b). Optimal sensitivity (74.2%) and specificity (81.4%) was reached with a cut-off of 39 points (Van Zelst et al. 2003b). Information about PTSS diagnoses can be found in the documentation Depression diagnoses and Anxiety diagnoses.
The SRIP total score is the sum of the scores on 22 items, with each item having a 4-point scale (1- not at all, 4 – extremely). The score ranges from 22 (‘low’) to 88 (‘maximum’) points. Imputation is performed in case of one or two missing items. In these cases, the average of the available items is imputed for the one or two missing items. No scale score is computed if more than two items are missing. The variable labeled ‘reason missing ptsd score’ gives further information regarding the reason for not having a score available.
LASAD091 / LASAE091;
LASAD291 / LASAE291 (scaled)
Availability of information per wave ¹
¹ More information about the LASA data collection waves is available here.
* 2B=baseline second cohort;
3B=baseline third cohort;
MB=migrants: baseline first cohort
Ma=data collected in main interview
Previous use in LASA
Van Zelst studied in LASA the criterion validity of the SRIP (see before), the prevalence of PTSD and subthreshold PTSD, its risk factors and the impact of (subthreshold) PTSD on daily functioning. She also showed that the September 11th attacks in the US had a profound effect on symptoms of PTSD in the Netherlands (Van Zelst et al. 2003c). The attacks caused temporarily a rise in PTSD symptomatology in the first week of October with an increase from 31.3 (SD = 7.6) to 34.2 (SD =7.6), an effect of medium size. This resulted in a 60% increase of subjects scoring beyond the recommended cut-off of 39 for caseness (Van Zelst et al., 2003a) (from 19 to 31% of the sample).
- Bramsen, I., 1995. The Long-term Psychological Adjustment of World War II Survivors in the Netherlands, Thesis. Eburon Press, Delft.
- Hidalgo RB, Davidson JRT: Posttraumatic stress disorder: Epidemiology and health-related considerations. J Clin Psychiatry 2000; 61(suppl 7):5–13.
- Hovens, J.E., van der Ploeg, H.M., Bramsen, I., Klaarenbeek, M.T.A., Schreuder, J.N., Rivero, V.V., 1994. The development of the self-rating inventory for posttraumatic stress disorder. Acta Psychiatr. Scand. 90, 172–183.
- Hovens, J.E., Bramsen, I., Van der Ploeg, H.M., 2000. Zelfinventarisatielijst Posttraumatische Stressstoornis ZIL Handleiding. Swets Test Publishers, Lisse.
- Van Zelst WH, de Beurs E, Beekman AT, Deeg DJ, Bramsen I, van Dyck R. Criterion validity of the self-rating inventory for posttraumatic stress disorder (SRIP) in the community of older adults. J Affect Disord. 2003a;76(1-3):229-235.
- Van Zelst WH, de Beurs E, Beekman AT, Deeg DJ, van Dyck R. Prevalence and risk factors of posttraumatic stress disorder in older adults. Psychother Psychosom. 2003a;72(6):333-342.
- Van Zelst W, de Beurs E, Smit JH. Effects of the September 11th attacks on symptoms of PTSD on community-dwelling older persons in the Netherlands. Int J Geriatr Psychiatry. 2003c;18(2):190.
- Van Zelst WH, de Beurs E, Beekman AT, van Dyck R, Deeg DD. Well-being, physical functioning, and use of health services in the elderly with PTSD and subthreshold PTSD. Int J Geriatr Psychiatry. 2006;21(2):180-188.
Date of last update: December, 2019