Abstract
BackgroundThis study examines the long-term outcomes of lifetime trauma exposure, including factors that contribute to the development of PTSD, in a sample of rural adults.MethodsIn 623 rural community residents, lifetime trauma exposure, PTSD, other psychiatric disorders and lifetime suicidal ideation were assessed using the World Mental Health Composite International Diagnostic Interview. Logistic regressions were used to examine relationships between potentially traumatic events (PTEs) and lifetime PTSD and other diagnoses.Results78.2 % of participants reported at least on PTE. Rates were broadly comparable with Australian national data: the most commonly endorsed events were unexpected death of a loved one (43.7 %); witnessing injury or death (26.3 %); and life-threatening accident (19.3 %). While the mean age of the sample was 55 years, the mean age of first trauma exposure was 19 years. The estimated lifetime rate of PTSD was 16.0 %. Events with the strongest association with PTSD were physical assault and unexpected death of a loved one. Current functioning was lowest among those with current PTSD, with this group reporting elevated psychological distress, higher mental health service use, a greater number of comorbidities, and lower perceived social support. Respondents with a past PTE but no PTSD history were generally similar in terms of their current wellbeing to those with no lifetime PTE.ConclusionsPTEs may have diverse psychological and social consequences beyond the development of PTSD. Ensuring that adequate support services are available in rural areas, particularly in the period immediately following a PTE, may reduce the long-term impact of traumatic events.
Highlights
This study examines the long-term outcomes of lifetime trauma exposure, including factors that contribute to the development of Post-Traumatic Stress Disorder (PTSD), in a sample of rural adults
Participants Data were obtained from the 2007–2009 baseline phase of the Australian Rural Mental Health Study (ARMHS), a longitudinal population study of mental health in rural and remote communities that has been described in detail previously [6]
The majority of our sample reported experiencing at least one lifetime potentially traumatic events (PTEs), which is broadly consistent with findings from other Australian [17, 18] and international studies [19, 20], rates vary with trauma definitions and sampling methods [21]
Summary
This study examines the long-term outcomes of lifetime trauma exposure, including factors that contribute to the development of PTSD, in a sample of rural adults. The compounding effect of multiple trauma exposure at both personal and community levels, along with lower availability of services and rural attitudes of selfreliance [3], suggest that rural residents may in turn have an increased likelihood of poorer health outcomes in the event of adversity, such as Post-Traumatic Stress Disorder (PTSD) [4]. This has been reflected in previous Canadian research, which shows a higher rate of PSTD in rural than urban regions [5]. There has been some research investigating the patterns of trauma exposures and outcomes in rural populations [1], these have largely focused on personal psychological outcomes alone, with few studies exploring a broad range of personal factors (such as levels of adversity, social networks) and community-level
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