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King, Andrew

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King

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Andrew

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King, Andrew
Author's Publications: search.filters.isAuthorOfPublication.e3d66adf-fa02-456e-875c-cea254e13d15

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    Post-traumatic stress disorder associated with life-threatening motor vehicle collisions in the WHO World Mental Health Surveys
    (BioMed Central, 2016) Stein, Dan J.; Karam, Elie G.; Shahly, Victoria; Hill, Eric D.; King, Andrew; Petukhova, Maria; Atwoli, Lukoye; Bromet, Evelyn J.; Florescu, Silvia; Haro, Josep Maria; Hinkov, Hristo; Karam, Aimee; Medina-Mora, María Elena; Navarro-Mateu, Fernando; Piazza, Marina; Shalev, Arieh; Torres, Yolanda; Zaslavsky, Alan; Kessler, Ronald
    Background: Motor vehicle collisions (MVCs) are a substantial contributor to the global burden of disease and lead to subsequent post-traumatic stress disorder (PTSD). However, the relevant literature originates in only a few countries, and much remains unknown about MVC-related PTSD prevalence and predictors. Methods: Data come from the World Mental Health Survey Initiative, a coordinated series of community epidemiological surveys of mental disorders throughout the world. The subset of 13 surveys (5 in high income countries, 8 in middle or low income countries) with respondents reporting PTSD after life-threatening MVCs are considered here. Six classes of predictors were assessed: socio-demographics, characteristics of the MVC, childhood family adversities, MVCs, other traumatic experiences, and respondent history of prior mental disorders. Logistic regression was used to examine predictors of PTSD. Mental disorders were assessed with the fully-structured Composite International Diagnostic Interview using DSM-IV criteria. Results: Prevalence of PTSD associated with MVCs perceived to be life-threatening was 2.5 % overall and did not vary significantly across countries. PTSD was significantly associated with low respondent education, someone dying in the MVC, the respondent or someone else being seriously injured, childhood family adversities, prior MVCs (but not other traumatic experiences), and number of prior anxiety disorders. The final model was significantly predictive of PTSD, with 32 % of all PTSD occurring among the 5 % of respondents classified by the model as having highest PTSD risk. Conclusion: Although PTSD is a relatively rare outcome of life-threatening MVCs, a substantial minority of PTSD cases occur among the relatively small proportion of people with highest predicted risk. This raises the question whether MVC-related PTSD could be reduced with preventive interventions targeted to high-risk survivors using models based on predictors assessed in the immediate aftermath of the MVCs. Electronic supplementary material The online version of this article (doi:10.1186/s12888-016-0957-8) contains supplementary material, which is available to authorized users.
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    Risk Factors for the Transition From Suicide Ideation to Suicide Attempt: Results From the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS)
    (American Psychological Association (APA), 2018-02) Han, Georges; Hwang, Irving; King, Andrew; Nock, Matthew; Millner, Alexander; Joiner, Thomas; Gutierrez, Peter; Naifeh, James; Sampson, Nancy; Zaslavsky, Alan; Stein, Murray; Ursano, Robert; Kessler, Ronald
    Prior research has shown that most known risk factors for suicide attempts in the general population actually predict suicide ideation rather than attempts among ideators. Yet clinical interest in predicting suicide attempts often involves the evaluation of risk among patients with ideation. We examined a number of characteristics of suicidal thoughts hypothesized to predict incident attempts in a retrospective analysis of lifetime ideators (n=3,916) drawn from a large (n=29,982), representative sample of U.S. Army soldiers. The most powerful predictors of first nonfatal lifetime suicide attempt in a multivariate model controlling for previously known predictors (e.g., demographics, mental disorders) were: recent onset of ideation, presence and recent onset of a suicide plan, low controllability of suicidal thoughts, extreme risk-taking or “tempting fate,” and failure to answer questions about the characteristics of one’s suicidal thoughts. A predictive model using these risk factors had strong accuracy (AUC=.93), with 66.2% of all incident suicide attempts occurring among the 5% of soldiers with highest composite predicted risk. This high concentration of risk in this retrospective study suggests that a useful clinical decision support model could be constructed from prospective data to identify those with highest risk of subsequent suicide attempt.