High Prevalence Of Traumatic Events Research Articles

The Relevance of Trauma and Re-experiencing in PTSD, Mood, and Anxiety Disorders

How traumatic events (TEs) should be defined, and how specific TEs are for Post-traumatic Stress Disorder (PTSD) were examined in a general mental health care population. Three definitions of TEs were defined, according to the PTSD criteria of DSM-IV. Half of the sample reported any TE, with a high prevalence of TEs among non-PTSD disorders. Previous mental health care, female gender, and the likelihood of assigning PTSD were associated with more severe trauma definitions. Reexperiencing symptoms were especially common among mood disorders. The implications for treatment are discussed and an alternative, dimensional definition of trauma has been proposed.

ICD-11 posttraumatic stress disorder (PTSD) in male prisoners

The eleventh version of the ICD, expected to be published in 2018, leads to changed criteria for post-traumatic stress disorder (PTSD) according to the online beta version. Such changes are likely to affect previously known features of PTSD, including the prevalence rate. Little is known about the prevalence of ICD-11 PTSD in imprisoned men. The present study examined this issue in this high-risk group for trauma disorders, as male prisoners are known to be more often affected by traumatic events compared to the general population. In n = 49 men imprisoned in Switzerland, cross-sectional and standardized self-assessment procedures (ACE, Cidi list, IES-R) were used to record traumatic events and possible trauma symptoms. The frequency of ICD-11 PTSD was calculated using the diagnostic heuristic of Hyland et al. (2017), on the basis of which ICD-11 PTSD is estimated by means of the IES-R. Overall, 88 % of the detained men examined had been traumatized during childhood and / or life span; 78 % reported at least one event on the ACE, on average 1.5, with 25 % reporting four or more events. Emotional abuse was reported most frequently (51 %). Furthermore, 71 % reported at least one event on the Cidi list, on average 1.8, with 45 % reporting serious physical threat. The analysis of ICD-11 PTSD was carried out with n = 34 inmates after exclusion of those without a traumatic event and those who did not complete the IES-R, and ICD-11 PTSD was estimated at 26.5 %. The study shows that imprisoned men are likely to be a high risk group for the development of PTSD even according to the new ICD. Considering the high prevalence of traumatic events and the numerous negative consequences for mental as well as physical health, specific psychotherapeutic programs and a trauma-informed imprisonment are necessary.

Psychological Interventions for Working with Trauma and Distressing Voices: The Future Is in the Past.

The relationship between stressful or traumatic life events and the content of experiences associated with a diagnosis of schizophrenia is clinically intriguing but lacks developed theoretical understanding. The high prevalence of traumatic events in this group indicates the need to develop psychosocial interventions. However, antipsychotic medication remains the frontline treatment within most mental health services, frequently prescribed by a doctor implicitly (or explicitly) imposing a simplistic disease model, along with the associated lack of hope for those who do not respond well. The essence of this model being that the distressing experiences associated with the diagnosis, typically paranoia and/or hearing voices, are abnormal and symptoms of a disease. Staying within a diagnostic approach, it is worth noting that recent studies suggest that ~15% of people diagnosed with schizophrenia will also present with experiences consistent with a diagnosis of posttraumatic stress disorder (PTSD; Achim et al., 2011). To date the clinical trials aimed at treating PTSD within this group suggest that exposure and eye movement desensitization and reprocessing (EMDR) are effective (Van den Berg et al., 2015) whilst cognitive restructuring alone may not be (Steel et al., 2017). It is likely that psychological interventions for this group will evolve alongside developments in evidence-based interventions for PTSD. Whilst 85% of people diagnosed with schizophrenia do not fulfill the diagnostic criteria for PTSD, the majority have suffered stressful and traumatic life events (Grubaugh et al., 2011). For many of these people, there appears to be a relationship between their life events and the content of their “psychotic” experiences. For example, Hardy et al. (2005) showed that whilst 12.5% of a sample heard distressing voices which were a direct repetition of a past traumatic event, 45% reported a broader emotional link, e.g., hearing a voice content which made them feel humiliated, replicating the emotional state they experienced during the trauma. There is a need to develop trauma informed approaches for this group, especially when considering the negative relationship between adverse life events and antipsychotic treatment outcome (Hassan and De Luca, 2015).

Conditional risk for posttraumatic stress disorder in an epidemiological study of a Brazilian urban population

IntroductionConditional risk for PTSD is the risk of developing PTSD after exposure to traumatic events. This epidemiological study of the general urban population from the two largest cities in Brazil reports exposure to traumatic events; conditional risk for PTSD; and proportion/estimated number of PTSD cases secondary to each type of traumatic event. MethodCross-sectional study of general population (15–75 y.o.) from Rio de Janeiro and São Paulo. PTSD was assessed through Composite International Diagnostic Interview 2.1. ResultsOur main findings, from 3744 participants, were: 1) high prevalence of traumatic events (86%), urban violence being the most common; 2) conditional risk for PTSD was 11.1%; 3) women (15.9%) have overall conditional risk 3 times higher than men (5.1%); 4) war-related trauma (67.8%), childhood sexual abuse (49.1%) and adult sexual violence (44.1%) had the highest conditional risks; 5) 35% of PTSD cases (estimated 435,970 individuals) were secondary to sudden/unexpected death of a close person, and 40% secondary to interpersonal violence. ConclusionsBrazilian urban population is highly exposed to urban violence, and overall conditional risk for PTSD was 11.1%. Violence prevention and enhancement of resilience should be part of public policies, and mental health sequelae of trauma should be better recognized and treated.

Adverse life events and health: A population study in Hong Kong

ObjectiveAlthough the effects of adverse life events on mental health have been well documented in the literature, there has never been a population based study that investigated systematically the association between history of adverse life events and physical health (objective and subjective) in adults. MethodCross-sectional, face-to-face household population based survey of adults (18+) in Hong Kong (N=1147). Participants were asked if they had a diagnosis of six health conditions including hypertension, heart disease, arthritis, diabetes, eyesight degeneration, and hearing loss. They were also asked if they had experienced five adverse life events including death of a partner or spouse, abuse, natural disaster, life threatening illness or injury, and family disruption. Interviews also included the Short-Form 12 Health Survey (SFHS-12) and the short version of the Centre for Epidemiologic Studies Depression Scale (CES-D). ResultsOverall, results indicate that specific adverse life events may be associated with specific health conditions. However, all tested life events were associated with subjective physical and mental health. Death of partner or parent and life threatening illness or injury were found to have the strongest association with physical health problems. A dose–response relationship between adverse life events and physical health in general was evident but more so for heart disease and eyesight degeneration. ConclusionConsidering the high prevalence of traumatic events and how common the conditions associated with such events are in the general population, screening for adverse life events as part of comprehensive assessment will allow a deeper understanding of patients' needs.

Associations between Lifetime Traumatic Events and Subsequent Chronic Physical Conditions: A Cross-National, Cross-Sectional Study

BackgroundAssociations between lifetime traumatic event (LTE) exposures and subsequent physical ill-health are well established but it has remained unclear whether these are explained by PTSD or other mental disorders. This study examined this question and investigated whether associations varied by type and number of LTEs, across physical condition outcomes, or across countries.MethodsCross-sectional, face-to-face household surveys of adults (18+) were conducted in 14 countries (n = 38, 051). The Composite International Diagnostic Interview assessed lifetime LTEs and DSM-IV mental disorders. Chronic physical conditions were ascertained by self-report of physician's diagnosis and year of diagnosis or onset. Survival analyses estimated associations between the number and type of LTEs with the subsequent onset of 11 physical conditions, with and without adjustment for mental disorders.FindingsA dose-response association was found between increasing number of LTEs and odds of any physical condition onset (OR 1.5 [95% CI: 1.4–1.5] for 1 LTE; 2.1 [2.0–2.3] for 5+ LTEs), independent of all mental disorders. Associations did not vary greatly by type of LTE (except for combat and other war experience), nor across countries. A history of 1 LTE was associated with 7/11 of the physical conditions (ORs 1.3 [1.2–1.5] to 1.7 [1.4–2.0]) and a history of 5+ LTEs was associated with 9/11 physical conditions (ORs 1.8 [1.3–2.4] to 3.6 [2.0–6.5]), the exceptions being cancer and stroke.ConclusionsTraumatic events are associated with adverse downstream effects on physical health, independent of PTSD and other mental disorders. Although the associations are modest they have public health implications due to the high prevalence of traumatic events and the range of common physical conditions affected. The effects of traumatic stress are a concern for all medical professionals and researchers, not just mental health specialists.

Prevalencia de acontecimientos potencialmente traumáticos en universitarios españoles

Title: Prevalence of potentially traumatic events in Spanish university stu- dents. Abstract: Aims: The high prevalence of traumatic events among different populations has been shown in several studies. The aim of the present study is to establish the prevalence of potentially traumatic events among Spanish university students. Methods: The sample comprised 1033 under- graduates (M = 21.71 years; SD = 2.63). Data were obtained using the Traumatic Life Events Questionnaire (TLEQ) (Kubany y Haynes, 2001). Results: Ninety-two per cent of subjects (93.4% males and 91.8% females) had been exposed to at least one potentially traumatic event. Males experi- enced a greater mean number of events than females (males = 3.86, SD = 2.60; females = 3.45, SD = 2.40). Sex differences were also found in the appraisal of events as being traumatic and causing major distress. Conclu- sions: Frequency of exposure to potentially traumatic events was higher in this sample of university students than in previous studies with similar samples. The results suggest the need for trauma screening and interven- tion, taking into consideration the substantial gender variation. Also the individual's appraisal for considering an event traumatic underlines the im- portance of taking the individual's perception into account. Key-words: Prevalence; trauma; university students; Spain.

Auditory Hallucinations and Posttraumatic Stress Disorder Within Schizophrenia and Substance Abuse

There is a high prevalence of traumatic events within individuals diagnosed with schizophrenia and of auditory hallucinations within individuals diagnosed with posttraumatic stress disorder (PTSD). However, the relationship among the symptoms associated with these disorders remains poorly understood. We conducted a multidimensional assessment of auditory hallucinations within a sample diagnosed with schizophrenia and substance abuse, both with and without comorbid PTSD. The results suggest a rate of comorbid PTSD similar to those reported in other studies. Patients who have comorbid PTSD reported more distressing auditory hallucinations. However, the hallucinations were not more frequent or of longer duration. The need for a multidimensional assessment is supported. The results are discussed within current theoretical accounts of traumatic psychosis.

Lifetime exposure to potentially traumatic events in a sample of alcohol‐dependent patients in Poland

Recent studies show a high prevalence of traumatic events in samples of patients with a substance use disorder. In the present study, the lifetime exposure to potentially traumatic events (PTEs) was estimated in a sample of 458 patients recruited at 17 randomly chosen alcohol-dependence treatment units in the public healthcare sector in Poland. Eighty percent of the patients reported a history of at least one potentially traumatic event. Sixty percent of them reported experiencing more than one probable trauma. However, only the patients who experienced physical assault reported worse clinical severity in posttraumatic stress and alcohol-use related symptomatology. The findings confirm the importance of trauma assessment in alcohol-dependent patients and the inclusion of trauma-related issues in the treatment of alcohol dependence.

Mental health, social functioning, and attitudes of Kosovar Albanians following the war in Kosovo.

The 1998-1999 war in Kosovo had a direct impact on large numbers of civilians. The mental health consequences of the conflict are not known. To establish the prevalence of psychiatric morbidity associated with the war in Kosovo, to assess social functioning, and to identify vulnerable populations among ethnic Albanians in Kosovo. Cross-sectional cluster sample survey conducted from August to October 1999 among 1358 Kosovar Albanians aged 15 years or older in 558 randomly selected households across Kosovo. Nonspecific psychiatric morbidity, posttraumatic stress disorder (PTSD) symptoms, and social functioning using the General Health Questionnaire 28 (GHQ-28), Harvard Trauma Questionnaire, and the Medical Outcomes Study Short-Form 20 (MOS-20), respectively; feelings of hatred and a desire for revenge among persons surveyed as addressed by additional questions. Of the respondents, 17.1% (95% confidence interval [CI], 13.2%-21.0%) reported symptoms that met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for PTSD; total mean score on the GHQ-28 was 11.1 (95% CI, 9.9-12.4). Respondents reported a high prevalence of traumatic events. There was a significant linear decrease in mental health status and social functioning with increasing amount of traumatic events (P</=.02 for all 3 survey tools). Populations at increased risk for psychiatric morbidity as measured by GHQ-28 scores were those aged 65 years or older (P =.006), those with previous psychiatric illnesses or chronic health conditions (P<.001 for both), and those who had been internally displaced (P =.009). Populations at risk for poorer social functioning were living in rural areas (P =.001), were unemployed (P =.046) or had a chronic illness (P =.01). Respondents scored highest on the physical functioning and role functioning subscales of the MOS-20 and lowest on the mental health and social functioning subscales. Eighty-nine percent of men and 90% of women reported having strong feelings of hatred toward Serbs. Fifty-one percent of men and 43% of women reported strong feelings of revenge; 44% of men and 33% of women stated that they would act on these feelings. Mental health problems and impaired social functioning related to the recent war are important issues that need to be addressed to return the Kosovo region to a stable and productive environment. JAMA. 2000;284:569-577