The Field's mall shooting: Post-traumatic stress reactions among survivors-Does diagnostic manual make a difference?

BACKGROUND: Recently, in addition to the increasing number of terrorist attacks and school shootings, mass shootings in public places by psychiatric patients have become more common. OBJECTIVE: To investigate the psychological sequelae following a mall shooting at Fields in Copenhagen according to two diagnostic manuals. METHOD: A sample of 85 adults who were present during the shooting were assessed half a year later for post-traumatic stress disorder (PTSD) with two questionnaires based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Diseases, 11th Revision (ICD-11), respectively, together with measures of comorbid disorders, psychological factors, and social support. Hierarchical multiple regression analyses were performed to study the effects of demographics, trauma exposure, and psychological factors on PTSD. RESULTS: The number of participants who met the ICD-11 criteria for PTSD (29.7 percent) was higher than the ones who met the similar/who met the corresponding criteria according to DSM-IV (20.0 percent). The final regression model included gender, injury, sick leave, self-efficacy, and dissociation. It explained 68.1 percent of the variation of PTSD based on ICD-11 and 72.8 percent of the variation based on DSM-IV. CONCLUSION: The present study expands disaster research with finding close similarities between two diagnostic systems and aligns disaster research on findings of the role of gender, injury, and psychological factors. The results also point to the need for a proactive approach to intervention.