Pervasive exposure to violence and posttraumatic stress disorder in a predominantly African American Urban Community: the Detroit Neighborhood Health Study

ArticleinJournal of Traumatic Stress 24(6):747-51 · December 2011with19 Reads
DOI: 10.1002/jts.20705 · Source: PubMed
Abstract
Exposure to traumatic events is common, particularly among economically disadvantaged, urban African Americans. There is, however, scant data on the psychological consequences of exposure to traumatic events in this group. We assessed experience with traumatic events and posttraumatic stress disorder (PTSD) among 1,306 randomly selected, African American residents of Detroit. Lifetime prevalence of exposure to at least 1 traumatic event was 87.2% (assault = 51.0%). African Americans from Detroit have a relatively high burden of PTSD; 17.1% of those who experienced a traumatic event met criteria for probable lifetime PTSD. Assaultive violence is pervasive and is more likely to be associated with subsequent PTSD than other types of events. Further efforts to prevent violence and increase access to mental health treatment could reduce the mental health burden in economically disadvantaged urban areas.
    • "As a result, scholars exploring outcomes associated with community violence exposure and victimization have paid particular attention to Black adolescents (Bailey, Hannigan, Delaney-Black, Covington, & Sokol, 2006; Rich & Grey, 2005; Voisin & Neilands, 2010). The link between victimization in the community and mental health, particularly depressive symptoms and post-traumatic stress disorder, among low-income, Black adolescents has received significant amount of research attention (Chen, 2010; Fitzpatrick, Piko, Wright, & LaGory, 2005; Gaylord-Harden, Cunningham, & Zelencik, 2011; Goldmann et al., 2011). One study (Chen, 2010 ), which compared the relationship between community violence exposure and internalizing problems of Black and Asian Adolescents , reported that internalizing problems due to community violence exposure was significant for Black and not Asian adolescents. "
    [Show abstract] [Hide abstract] ABSTRACT: As the United States enters a demographic landscape where racial and ethnic minorities will represent more than half of the adolescent population, this current state-of-the art review highlights pertinent research that focuses on race/ethnicity for interpersonal adolescent violence published between 2005 and 2015.
    Full-text · Article · Sep 2016 · Social Science [?] Medicine
    • "Considerably less attention has been devoted to reactions to traumas which are not only prolonged, but ongoing at the time of diagnosis . Ongoing traumatic stress response (OTSR; Diamond, Lipsitz, Fajerman, & Rozenblat, 2010Stevens et al., 2013 ), the term has also been applied to instances of ongoing missile shelling threats (e.g., Diamond et al., 2013), the continuous threat of potential terrorist attacks (Marshall et al., 2007), and may similarly be applied (but currently is not) to continuous urban violence (e.g., Goldmann et al., 2011) and prison violence (e.g., Roach, 2013). It is well recognized that a primary task in cases of stress involves the restoration of safety and its concomitant sense of security. "
    [Show abstract] [Hide abstract] ABSTRACT: Posttraumatic stress disorder (PTSD) is a psychiatric pathology wherein the precipitating traumatic event is essential for diagnostic eligibility (Criterion A). This link is substantiated throughout PTSD’s development as a diagnosis. However, while traumatic events may vary considerably, this variation currently bears nearly no implications for psychiatric nosology. Consequently, PTSD remains a semi-unified diagnostic construct, consisting of no Criterion-A-determined subtypes of adult PTSD. The question addressed by the current paper is then does one size truly fit all? Making an argument for the negative, the paper briefly reviews complex PTSD (CPTSD), ongoing traumatic stress response (OTSR), and cumulative traumas, all of which are exemplars wherein Criterion A specification is crucial for understanding the emerging symptomatology and for devising appropriate interventions. Indicating several overlooked discrepancies in the PTSD literature, the paper urges for the necessity of a more fine-grained differential diagnostic subtyping of PTSD, wherein posttraumatic reactions are more closely associated with their precipitating traumatic events. The paper concludes by suggesting diagnostic, clinical and societal implications, as well as proposing directions for future research.
    Article · Jul 2016 · Social Science [?] Medicine
    • "The construction of PTSD as a 'hero's disorder' could potentially hinder the passage of targeted policies that address the disorder, and other sequelae of trauma, among trauma-exposed civilians who are not considered to possess the positive attributes of heroism. For example, elevated rates of violent crime in low-income urban communities, primarily comprised of racial and ethnic minorities , place residents at increased risk for trauma exposure and PTSD (Breslau et al., 1991Breslau et al., , 1998Breslau et al., , 2004 Brewin et al., 2000; Goldmann et al., 2011; Lowe et al., 2014 ). In contrast to the celebrated qualities of war heroes, residents of these communities are often negatively portrayed in the media (Kang, 2005 ) and stereotyped as dangerous (Hurwitz and Peffley, 1997) and economically dependent (Bullock et al., 2001). "
    [Show abstract] [Hide abstract] ABSTRACT: Public policies contribute to the social construction of mental health problems. In this study, I use social constructivist theories of policy design and the methodology of ethnographic content analysis to qualitatively explore how posttraumatic stress disorder (PTSD) has been constructed as a problem in US federal legislation. I analyzed the text of 166 bills introduced between 1989 and 2009 and found that PTSD has been constructed as a problem unique to combat exposures and military populations. These constructions were produced through combat-related language and imagery (e.g., wounds, war, heroism), narratives describing PTSD as a military-specific phenomenon, and reinforced by the absence of PTSD in trauma-focused legislation targeting civilians. These constructions do not reflect the epidemiology of PTSD-the vast majority of people who develop the disorder have not experienced combat and many non-combat traumas (e.g., sexual assault) carry higher PTSD risk-and might constrain public and political discourse about the disorder and reify sociocultural barriers to the access of mental health services.
    Full-text · Article · Dec 2015
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