Year: 2017
Type: article
Abstract: Background: Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their ‘worst.’Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD.Method: WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the ‘worst’ lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview.Results: In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk.Conclusions: Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits within months after onset, mean symptom duration is considerably longer than previously recognized.
Authors: Ronald C. Kessler, Sergio Aguilar-Gaxiola, Jordi Alonso, Corina Benjet, Evelyn J. Bromet, Graça Cardoso, Louisa Degenhardt, Giovanni de Girolamo, Rumyana V. Dinolova, Finola Ferry, Silvia Florescu, Oye Gureje, Josep Maria Haro, Yueqin Huang, Elie G. Karam, Norito Kawakami, Sing Lee, Jean-Pierre Lepine, Daphna Levinson, Fernando Navarro-Mateu, Beth-Ellen Pennell, Marina Piazza, José Posada-Villa, Kate M. Scott, Dan J. Stein, Margreet Ten Have, Yolanda Torres, Maria Carmen Viana, Maria V. Petukhova, Nancy A. Sampson, Alan M. Zaslavsky, Karestan C. Koenen
Institutions: Harvard University, UC Davis Health, Universitat Pompeu Fabra, Municipal Institute for Medical Research, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Hospital del Mar Research Institute, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Stony Brook University, Lisbon Institute of Global Mental Health, Universidade Nova de Lisboa, UNSW Sydney, National Drug and Alcohol Research Centre, Centro San Giovanni di Dio Fatebenefratelli, Istituti di Ricovero e Cura a Carattere Scientifico, National Center of Public Health and Analyses, University of Ulster, National School of Public Health, Management and Professional Development, University College Hospital, Ibadan, Centro de Investigación Biomédica en Red de Salud Mental, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Peking University, University of Balamand, Saint George Hospital, Institute for Development, Research, Advocacy and Applied Care, The University of Tokyo, Chinese University of Hong Kong, Inserm, Assistance Publique – Hôpitaux de Paris, Hôpital Fernand-Widal, Hôpital Lariboisière, Université Paris Diderot, Optimisation Thérapeutique en Neuropsychopharmacologie, Israel Ministry of Health, Instituto Murciano de Investigación Biosanitaria, Servicio Murciano de Salud, University of Michigan, Institute for Social Research, Universidad Peruana Cayetano Heredia, Instituto Nacional de Salud, Universidad Colegio Mayor de Cundinamarca, University of Otago, University of Cape Town, Trimbos Institute, Universidad CES, Universidade Federal do Espírito Santo
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $1,704
Awards: G1037158725, G1523913859, G2237026874, G2412493501, G2901801384, G328221351, G33223526, G473472693, G5269232963, G580704126, G6667095330, Epidemiology - National Comorbidity Survey Replication, G8009662236, G8076878428, G851565850, Lebanon-Epidemiology: The NCS Replication Study, G8721603200
OpenAlex ID: W2740846930