The Epidemiology of Trauma, PTSD, and Other Posttrauma Disorders
Department of Epidemiology, Michigan State University College of Human Medicine, USA.Trauma Violence & Abuse (Impact Factor: 3.27). 04/2009; 10(3):198-210. DOI: 10.1177/1524838009334448
Epidemiologic studies have reported that the majority of community residents in the United States have experienced posttraumatic stress disorder (PTSD)-level traumatic events, as defined in the DSM-IV. Only a small subset of trauma victims develops PTSD (<10%). Increased incidence of other disorders following trauma exposure occurs primarily among trauma victims with PTSD. Female victims of traumatic events are at higher risk for PTSD than male victims are. Direct evidence on the causes of the sex difference in the conditional risk of PTSD is unavailable. The available evidence suggests that the sex difference is not due to (a) the higher occurrence of sexual assault among females, (b) prior traumatic experiences, (c) preexisting depression or anxiety disorder, or (d) sex-related bias in reporting. Observed sex differences in anxiety, neuroticism, and depression, inducing effects of stressful experiences, might provide a theoretical context for further inquiry into the greater vulnerability of females to PTSD.
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- "PTS symptoms are one of the many consequences of violence exposure (Margolin & Vickerman, 2007) and commonly include reexperiencing of the traumatic event, intrusive thoughts, difficulty concentrating, nightmares, numbing, and increased arousal (American Psychiatric Association, 2000). Although PTS symptoms may co-occur with behavior problems , the two are different: PTS symptoms are often tied to a particular traumatic event that leads to these symptoms and a fear of reexperiencing similar negative events in the future (Breslau, 2009). PTS symptoms may produce behavior problems in children, as these symptoms manifest in greater instances of depression and anxiety (i.e., internalizing symptoms ) or aggressive and delinquent behaviors (i.e., externalizing symptoms; De Bellis, 2001). "
ABSTRACT: In this study we investigated whether witnessing violence and violence victimization were associated with children's internalizing and externalizing behavior problems and examined the mediating role of posttraumatic stress (PTS) symptoms in these relationships. Secondary data analysis was conducted using 3 waves of data from the National Survey of Child and Adolescent Well-Being. Path analyses were conducted to test direct and indirect effects of violence exposure on behavior problems, using 2,064 children (ages 8-15 years) reported to Child Protective Services for maltreatment. Being a victim of violence in the home was directly associated with more internalizing (β = .06, p = .007) and externalizing behavior problems (β = .07, p = .002), whereas witnessing violence was not directly related to either internalizing (β = .04, p = .056) or externalizing behavior problems (β = .03, p = .130). PTS symptoms mediated the effects of witnessing violence and violence victimization on internalizing behavior problems (β = .02, p = .002). Our findings suggest that PTS symptoms may be a mechanism underlying the association between violence exposure and internalizing behavior problems (R(2) = .23), underscoring the potential importance of assessing PTS symptoms and providing targeted trauma-focused interventions for children exposed to violence at home.
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- "This review also analyses depression, substance use disorder (SUD), and anxiety disorders, which are recognized as further important posttrauma disorders and the most common comorbid conditions of PTSD (Brady, Killeen, Brewerton, & Lucerini, 2000; Knox, 2008). Given its association with trauma exposure, this review also explores suicidal behavior (Breslau, 2009). This review centers on three subject areas. "
ABSTRACT: Background: Working in humanitarian crisis situations is dangerous. National humanitarian staff in particular face the risk of primary and secondary trauma exposurewhich can lead to mental health problems. Despite this, research on the mental health of national staff is scarce, and a systematic analysis of up-to-date findings has not been undertaken yet. Objective: This article reviews the available literature on trauma-related mental health problems among national humanitarian staff. It focuses on the prevalence of selected mental health problems in relation to reference groups; sex and/or gender as predictive factors of mental health problems; and the influence of organization types on mental health problems. Method: Three databases were systematically searched for relevant studies published in the English language in peer-reviewed journals. Results: Fourteen articles matched the inclusion criteria. Findings suggest that national staff experience mental health problems and the prevalence of posttraumatic stress disorder, depression, and anxiety among this occupation group is mostly similar to or higher than among reference groups. Research on both substance use disorder and suicidal behavior among national staff is particularly scarce. The relation between sex and/or gender and mental health problems among national staff appears to be complex, and organizational staff support seems to be an important determinant for mental health.
- "Meta-analysis has demonstrated reduced HCV in many neuropsychiatric disorders, including depression (McKinnon et al., 2009; Videbech and Ravnkilde, 2004), post-traumatic stress disorder (PTSD; Smith, 2005; Woon and Hedges, 2011), schizophrenia (Adriano et al., 2012), borderline personality disorder (BPD; Ruocco et al., 2012), Alzheimer's disease (Barnes et al., 2009), and mild cognitive impairment (MCI; Shi et al., 2009). Since many of these disorders show higher prevalence in women (Breslau, 2009; Johnson et al., 2003; Kessler et al., 2003; McLean et al., 2011; Moschetti et al., 2012), it is reasonable to suspect that a pre-morbid sex difference in HCV—i.e., smaller in females—contributes to this differential vulnerability. Indeed, research in rats and voles has led to the hypothesis that sexual selection for spatial ability produced an expansion of male HCV in polygynous species, including humans (Sherry et al., 1992). "
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