Danielson, Carla KmettCohen, JosephAdams, Zachary W.Youngstrom, Eric A.Soltis, KathrynAmstadter, Ananda B.Ruggiero, Kenneth J.2024-10-032024-10-032017Danielson CK, Cohen JR, Adams ZW, et al. Clinical Decision-Making Following Disasters: Efficient Identification of PTSD Risk in Adolescents. J Abnorm Child Psychol. 2017;45(1):117-129. doi:10.1007/s10802-016-0159-3https://hdl.handle.net/1805/43754The present study aimed to utilize a Receiver Operating Characteristic (ROC) approach in order to improve clinical decision-making for adolescents at risk for the development of psychopathology in the aftermath of a natural disaster. Specifically we assessed theoretically-driven individual, interpersonal, and event-related vulnerability factors to determine which indices were most accurate in forecasting PTSD. Furthermore, we aimed to translate these etiological findings by identifying clinical cut-off recommendations for relevant vulnerability factors. Our study consisted of structured phone-based clinical interviews with 2000 adolescent-parent dyads living within a 5-mile radius of tornados that devastated Joplin, MO, and northern Alabama in Spring 2011. Demographics, tornado incident characteristics, prior trauma, mental health, and family support and conflict were assessed. A subset of youth completed two behavioral assessment tasks online to assess distress tolerance and risk-taking behavior. ROC analyses indicated four variables that significantly improved PTSD diagnostic efficiency: Lifetime depression (AUC = .90), trauma history (AUC = .76), social support (AUC = .70), and family conflict (AUC = .72). Youth were 2-3 times more likely to have PTSD if they had elevated scores on any of these variables. Of note, event-related characteristics (e.g., property damage) were not related to PTSD diagnostic status. The present study adds to the literature by making specific recommendations for empirically-based, efficient disaster-related PTSD assessment for adolescents following a natural disaster. Implications for practice and future trauma-related developmental psychopathology research are discussed.en-USPublisher PolicyAdolescentsEvidence-based assessmentPTSD risk assessmentStress disordersTraumatic stressArticle