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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Cumulative traumas and risk thresholds: 12-month ptsd in the world mental health (WMH) surveys
Depression and Anxiety, Volume 31, No. 2, Year 2014
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Description
Background: Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods: Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n = 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results: 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyperarousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions: A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more "complex" clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. © 2013 Wiley Periodicals, Inc.
Authors & Co-Authors
Karam, Elie Georges
Lebanon, Beirut
Saint George Hospital University Medical Center
Friedman, Matthew J.
United States, Washington, D.c.
U.s. Department of Veterans Affairs
Hill, Eric D.
United States, Boston
Harvard Medical School
Kessler, Ronald C.
United States, Boston
Harvard Medical School
McLaughlin, Katie A.
United States, Boston
Boston Children's Hospital
Petukhova, Maria V.
United States, Boston
Harvard Medical School
Sampson, Laura A.
United States, Boston
Harvard Medical School
Shahly, Victoria
United States, Boston
Harvard Medical School
Angermeyer, Matthias Claus
Austria, Vienna
Center for Public Mental Health
Bromet, Evelyn J.
United States, Stony Brook
Renaissance School of Medicine at Stony Brook University
de Girolamo, Giovanni
Italy, Bologna
Irccs Rizzoli Orthopaedic Institute, Bologna
de Graaf, Ron
Netherlands, Utrecht
Trimbos Institute, Netherlands Institute of Mental Health and Addiction
Demyttenaere, Koen
Belgium, Leuven
Ku Leuven– University Hospital Leuven
Ferry, F.
United Kingdom, Coleraine
Ulster University
Florescu, Silvia E.
Romania, Bucharest
Scoala Nationala de Sanatate Publica si Management Sanitar, Bucharest
Haro, Josep Maria
Spain, Barcelona
Universitat de Barcelona
He, Yanling
China, Shanghai
Shanghai Jiao Tong University School of Medicine
Karam, Aimée Nasser
Lebanon, Beirut
Saint George Hospital University Medical Center
Kawakami, Norito
Japan, Tokyo
Graduate School of Medicine
Kovess - Masfety, Viviane
France, Paris
Université Paris Cité
Medina-Mora, M. E.
Mexico, Mexico
Instituto Nacional de Psiquiatría Ramon de la Fuente
Oakley-Browne, Mark A.
Unknown Affiliation
Posada-Villa, J. A.
Colombia, Bogota
Instituto Colombiano Del Sistema Nervioso
Shalev, Arieh Y.
Israel, Jerusalem
Hadassah University Medical Centre
Stein, Dan J.
South Africa, Cape Town
University of Cape Town
Viana, Maria Carmen
Brazil, Vitoria
Universidade Federal do Espírito Santo
Zarkov, Zahari N.
Bulgaria, Sofia
National Center of Public Health Protection Bulgaria
Koenen, Karestan Chase
United States, New York
Mailman School of Public Health
Statistics
Citations: 351
Authors: 28
Affiliations: 22
Identifiers
Doi:
10.1002/da.22169
ISSN:
10914269
e-ISSN:
15206394
Research Areas
Mental Health
Violence And Injury
Study Design
Randomised Control Trial
Cross Sectional Study
Study Approach
Quantitative