All Symptoms Are Not Created Equal: The Prominent Role of Hyperarousal in the Natural Course of Posttraumatic Psychological Distress

J Abnorm Psychol. 2004 May;113(2):189-97. doi: 10.1037/0021-843X.113.2.189.


This 3-wave longitudinal study examined the natural course of posttraumatic stress disorder symptoms using data collected from young adult survivors of community violence. Three key findings emerged. 1. Mean levels of distress for each symptom cluster decreased over time, with reexperiencing decreasing most rapidly. 2. Cross-lagged panel analysis revealed that hyperarousal strongly influences, but is not generally influenced by, other symptoms clusters. 3. Trajectory analysis demonstrated that respondents for whom hyperarousal was the most pronounced baseline symptom showed lower overall symptom improvement relative to trauma exposed counterparts for whom hyperarousal was a less prominent early symptom. Implications for theory, research, and clinical practice are discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Arousal*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Prospective Studies
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / psychology*
  • Surveys and Questionnaires
  • Time Factors