HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS Psychiatric Bulletin Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Mol, S. S. L. Articles by Knottnerus, J. A. Search for Related Content PubMed Articles by Mol, S. S. L. Articles by Knottnerus, J. A.

Authors’ reply

Department of General Practice, Julius Centre, Stratenum 6.108, UMC Utrecht, The Netherlands.

A. Arntz

Department of Medical, Clinical and Experimental Psychology, Maastricht University, The Netherlands

J. F. M. Metsemakers, G.-J. Dinant, P. A. P. Vilters-van Monfort and J. A. Knottnerus

Department of General Practice, Maastricht University, The Netherlands

Correspondence: E-mail: s.s.l.mol{at}umcutrecht.nl

Declaration of interest

The Achmea Foundation for Victim Support in Society paid the salary of S.S.L.M. but had no influence on the methodology or analyses of the study.

We thank Ben-Ezra & Aluf (2005) for their letter, in which they broadly support our findings (Mol et al, 2005) that life events may cause as many symptoms of post-traumatic stress disorder (PTSD) as traumatic events classified according to the A1 criterion of the DSM–IV. However, they also have some criticisms. Ben-Ezra & Aluf argue that ‘serious illness (self)’ – classified as a life event in our study – can be considered a traumatic event. We decided against this classification as many respondents had experienced an illness that was chronic but not life-threatening in the short term. However, when we re-analysed the data with ‘serious illness (self)’ as a traumatic event the PTSD scores of the traumatic and life events groups still did not differ (total log PTSD score 0.68 in both groups).

As suggested by Ben-Ezra & Aluf we have also excluded accidents and sudden deaths from the trauma events group, since this might be a heterogeneous group regarding the magnitude of the event. This resulted in a mean total log PTSD score of 0.76 (v. 0.71), which is not an essential change compared with the original difference.

Ben-Ezra & Aluf argue that the magnitude (severity) of an event is related to the likelihood of developing PTSD, and that we should have allotted events to either of our two groups on the basis of their severity. We agree that symptoms are related to severity but we found a striking overlap in PTSD symptomatology after life events and traumatic events (Tables 2 and 4) and similar mean symptom levels (Table 3).

The severity of an event can be assessed objectively and subjectively. Ben-Ezra & Aluf allude to the objective assessment but the subjective appraisal of an experience also plays an important role (McNally et al, 2003). It is likely that objective and subjective severity are associated with PTSD symptoms after both traumatic and life events.

REFERENCES

Ben-Ezra, M. & Aluf, D. (2005) Traumatic events v. life events: does it really matter? British Journal of Psychiatry, 188, 83 –84.

McNally, R. J., Bryant, R. A. & Ehlers, A. (2003) Does early psychological intervention promote recovery from posttraumatic stress? Psychological Science in the Public Interest, 4, 45 –79.[CrossRef]

Mol, S. S. L., Arntz, A., Metsemakers, J. F. M., et al (2005) Symptoms of post-traumatic stress disorder after non-traumatic events: evidence from an open population study. British Journal of Psychiatry, 186, 494 –499.[Abstract/Free Full Text]

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Mol, S. S. L. Articles by Knottnerus, J. A. Search for Related Content PubMed Articles by Mol, S. S. L. Articles by Knottnerus, J. A.