The purpose of the proposed extension of the present study is to investigate generic and specific symptom patterns in responses to extreme stress, and to attempt to delineate a spectrum of stress response syndromes within and between traumatic events. No new data will be collected. Four samples from three different catastrophic events (the Buffalo Creek dam collapse and flood, the Beverly Hills Supper Club fire, and the Vietnam war) have comparable data that can be used for direct, across event comparisons. Eight hundred six survivors from the three events have been interviewed and have filled our self-report data; 130 of the Buffalo Creek survivors have 14-year followup data. We will investigate patterns of symptoms and diagnoses that characterize individuals exposed to extreme stress regardless of event type, patterns that differentiate events, and patterns related to age and gender. The relationship that these patterns of psychopathology and symptomatology have with externally grounded indices of life adjustment will also be examined. Data analyses will investigate which symptoms are associated with post-traumatic stress disorder across samples and an attempt will be made to develop subsets of self-report items that are highly correlated with PTSD. Profiles will be developed of the clinically rated psychopathology and the self-report symptoms that describe the survivors as a whole, survivors of specific events, and age and gender subgroups, when available. Further, the study will investigate whether highly stressed survivors manifest one clear-cut syndrome that corresponds to the psychiatric nosology, or whether they are better described by several different types of stress response syndromes or disorders. The information that is obtained is expected to lead to recommendations for changes in the psychiatric nosology that are empirically based and have some generalizability across events.
