Lifetime Prevalence Of Posttraumatic Stress Disorder Research Articles

Post-traumatic stress disorder in a national sample of preadolescent children 9 to 10 years old: Prevalence, correlates, clinical sequelae, and treatment utilization

Although posttraumatic stress disorder (PTSD) has been well characterized in adults, its epidemiology in children is unclear. The current study provides the first population-based examination of the prevalence of PTSD, sociodemographic and psychiatric correlates, clinical sequelae, and associations with psychiatric treatment in preadolescents 9-10 years old in the United States. Data from the Adolescent Brain and Cognitive Development (ABCD) Study (release 5.0) was analyzed. Participants (unweighted n = 11,875) were recruited from 21 sites across the United States. Current and lifetime PTSD prevalence were estimated, as was treatment use among children with PTSD. Sociodemographic, psychiatric correlates and sequelae of PTSD were analyzed using logistic regression, as was the association between PTSD and psychiatric treatment. After the application of propensity weights, lifetime prevalence of PTSD was 2.17%. Sexual minority status, being multiracial, having unmarried parents, and family economic insecurity were associated with greater odds of PTSD. Among psychiatric disorders, separation anxiety was most strongly associated with PTSD, although general comorbid psychopathology was associated with greater odds of PTSD. Prior history of PTSD predicted a new onset of other psychiatric disorders after PTSD remission. Nearly one in three children with lifetime PTSD did not receive psychiatric treatment, despite negative long-term outcomes of PTSD and significant psychiatric comorbidity. Even among preadolescents who experience full remission of PTSD, a significant risk for future psychiatric illness remains. Further, the current findings underscore the need for improved efforts to reduce unmet treatment needs among those with PTSD at this age.

POST-TRAUMATIC STRESS DISORDER FOR MILITARY SERVANTS: THEORY, RESEARCH AND TREATMENT

Military service is associated with exposure to traumatic stressors, including war zone hazards, accidents, and other occupational hazards, which may place military personnel at increased risk for the developing post-traumatic stress disorder (PTSD). The overall lifetime prevalence of PTSD among the world’s population varies between 10.0-11.3% for women and 5.0-6.0% for men. Among military veterans, the lifetime prevalence of the disorder is 13.4% and 7.7% for women and men, respectively.
 The United States Department of Veterans Affairs and the United States Department of Defense recommend a clinical methodology for the treatment of PTSD, which includes the following components: a diagnosis based on the criteria of the “Diagnostic and Statistical Manual of Mental Disorders” of the American Psychiatric Association; the presence of a high risk of harming oneself or others; functional status including duty and level of work responsibility; risk and protective factors; treatment history; medical history of the patient and his family. At the same time, joint decision-making with the patient is assumed, the key components of which are taking into account the patient’s preferences, educating the patient and his relatives with the concept of psychological trauma and the peculiarities of the course of PTSD, joint consideration with the patient of the advantages and disadvantages of available treatment options. The PTSD treatment process necessarily must be trauma-oriented and include the following types of psychotherapy: prolonged exposure, cognitive processing therapy, cognitive-behavioral therapy, brief eclectic psychotherapy, narrative exposure therapy, eye movement desensitization and reprocessing, and written exposure therapy. For situations where clinicians are not trained in trauma-focused psychotherapy or when patients refuse to initiate treatment, pharmacotherapy or non-trauma-focused manualized psychotherapy that includes stress resistance training, life-focused therapy, and interpersonal psychotherapy is recommended.
 Despite certain successes in the treatment of PTSD, important questions remain unsolved. First of all, there is a lack of clinical research to compare the effectiveness of the many available psychological treatments in general and for active-duty military personnel in particular. It is necessary to continue research in the field of precision medicine, which will make it possible to choose the most effective treatment for PTSD for each serviceman individually. To resolve these and similar issues, further long-term, consistent studies conducted on representative samples are needed.

Prevalence, Severity and Burden of Post-Traumatic Stress Disorder in Black Men and Women Across the Adult Life span.

Objectives: To examine post-traumatic stress disorder (PTSD) among Black adults in younger, middle, and older ages. Methods: Using nationally representative data from the National Survey of American Life, we estimated lifetime and 12-month prevalence of PTSD in Black men and women ages 18-34, 35-49, and 50+. We determined PTSD persistence and severity by age group, then associations of PTSD with socio-economic status, chronic stress, and racial discrimination in middle age. Results: The lifetime prevalence of PTSD was higher in Black women/men ages 18-34 (prevalence=14.0%/6.3%) and 35-49 (12.8%/4.6%) versus 50 and older (8.7%/5.1%). Those ages 35-49 were more likely than younger/older Black adults to have severe interference in work, relationships, and activities domains. In middle age, PTSD was associated with unemployment, lower education, poverty, and stress in Black men, and unemployment, divorce, poverty, stress, and discrimination in Black women. Discussion: Black women experience a disproportionate burden of PTSD in middle age.

Result of Music Therapy on Post-Traumatic Stress Disorder.

Madam, in these challenging times stress, has affected every age group. Around 50% of all males and females’ experience post-traumatic stress disorder (PTSD) in their lives(1). Music has proved to be effective to deal with PTSD after an evaluation done by a study showed that patients undergoing music therapy had a significant decrease in PTSD when compared to those patients who did not take any therapy(2). Even though all these measures cross- national lifetime prevalence of PTSD was 3.9 % cross-nationally, half of all global cases were persistent(3). Despite of these deteriorating effects, no preventive and rehabilitative measures can be seen in Pakistan. A study in 2019 concluded that active music-instruction programmes hold promise to alleviate PTSD and depressive symptoms among the population globally(4). Further, people treated with music therapy had a significant mean difference [p = 0.0035] when contrasted with those who did not undergo treatment.(2). A study in 2016 concluded that the prevalence of PTSD in Pakistan was 26% (78 out of 299 individuals)(5). During the covid-19 pandemic, another study records this percentage to have risen up to 40.2% by June 2020(1). It is evident that PTSD had harmed the population with its radical escalation in pre and post covid-19 pandemic., Therefore it is, crucial to take steps in the right direction by increasing awareness in public and introducing viable and cost-effective methods that are easily accessible to people and aid in resolving this dilemma in its early stages during these challenging times. Implementation of various methods is crucial to reduce the prevalence of PTSD during Covid-19 in Pakistan. Music therapy can serve as one of the interventions to reduce the bars of PTSD in Pakistan significantly.

Posttraumatic Stress Disorder in US Military Veterans: Results From the 2019-2020 National Health and Resilience in Veterans Study.

Objective: The US military veteran population is changing rapidly, and contemporary data on the prevalence of DSM-5 posttraumatic stress disorder (PTSD) are lacking. The DSM-5 clarified PTSD Criterion A to delineate direct and indirect trauma exposures, but effects on the conditional probability of PTSD and functional impairment remain unknown. The objectives of this study were to provide contemporary estimates of PTSD prevalence and conditional probabilities in the US military veteran population, determine the likelihood of developing PTSD following direct versus indirect exposures to potentially traumatic events (PTEs), and examine the effects of direct and indirect PTEs and PTSD on functional impairment.Methods: Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), an online survey of a nationally representative sample of US military veterans conducted from November 2019 to March 2020 (median completion date: November 21, 2019). Trauma exposures were assessed with the Life Events Checklist-5 and PTSD with the PTSD Checklist for DSM-5.Results: The weighted prevalence of lifetime PTSD was 9.4% (95% CI, 8.5%-10.3%) and of past-month PTSD was 5.0% (95% CI, 4.3%-5.7%). Direct PTEs were associated with increased odds of lifetime (odds ratio [OR] = 1.36; 95% CI, 1.30-1.42) and past-month PTSD (OR = 1.38; 95% CI, 1.31-1.46), but indirect PTEs were not (lifetime OR = 1.01; 95% CI, 1.00-1.03; past-month OR = 0.99; 95% CI, 0.97-1.00). Both PTSD (unstandardized B = 6.11, SE = 0.35) and direct PTEs (unstandardized B = 0.13, SE = 0.04), but not indirect PTEs, were significantly associated with functional impairment after adjustment for demographic and psychiatric variables.Conclusions: The prevalence of lifetime PTSD in US military veterans (9.4%) is slightly higher than 2016 estimates (6.9%-8.1%). Direct and indirect PTEs are prevalent in US military veterans, with only direct PTEs associated with higher conditional probability of past-month PTSD and greater functional impairment.

The risk of post-traumatic stress disorder (PTSD) in Italian Highly Specialized Research Hospitals staff within two months of the pandemic declaration: an on-line survey.

The whole hospital system was stressed and at risk in the first phase of the pandemic. This study examined the prevalence of post-traumatic stress disorder (PTSD) in all hospital staff, medical and non-medical, within two months of the pandemic declaration. Survey concerned staff 4510 health workers of Italian Highly Specialized Research Hospitals. Subjects were asked to complete an on-line self-reported questionnaire, the PTSD Checklist 5 (PCL-5) and subjective perception of safety related to personal protective equipment (PPE). The sample included staff working in hospitals with or without COVID-19 patient admissions. Overall, 11.56% of the hospitals staff met the symptoms criteria for probable PTSD. The sample included 80.63% (3467) medical staff workers and 19.37% (833) non-medical staff workers. The 31.91% of participants worked in COVID-19 hospitals/wards. The prevalence of positive screening for PTSD symptoms in medical staff was 12.42% (426) and in non-medical staff, 8.59% (70). Among medical staff, anesthesiologists had a significant prevalence of PTSD (22.35%), followed by health care assistants/technicians (15.38%) and physicians (10.11%). Among non-medical staff, personnel involved in cleaning, catering, maintenance, security, and transportation, the symptoms of PTSD reached a rate of 12.24% and in administrative staff 8.47%. Risk factors associated with PTSD included working as an anesthesiologist, perceiving PPE as inadequate, and working in COVID-19 hospitals/wards. In the present study, as in other studies, the prevalence of PTSD symptoms among hospital workers was significatively higher than the lifetime prevalence of PTSD in the general population, showing the pandemic's incredible impact.

Estimating prevalence of PTSD among veterans with minoritized sexual orientations using electronic health record data.

Objective: Questionnaire studies show people with minoritized sexual orientations (MSOs) face increased risk for conditions including posttraumatic stress disorder (PTSD). This study replicated Harrington et al.'s (2019) electronic health record probabilistic algorithm to evaluate lifetime PTSD prevalence in Veterans Health Administration (VHA)-using veterans. Method: In 115,853 MSO veterans and a 1:3 matched (on sex assigned at birth, and age at and year of first VHA visit) sample of non-MSO veterans. Each veteran was given a probability of "likely PTSD" (0.0-1.0) and thresholds (e.g., 0.7) applied to minimize false positive classifications. Results: Veterans with MSO were 2.35 times, CI [2.33, 2.38], more likely to have "likely PTSD" than veterans with non-MSO. The prevalence of "likely PTSD" using the rule-based International Classification of Diseases (ICD) approach was 40.8% among the MSO group compared to 22.0% among the non-MSO group after excluding those with bipolar or schizophrenia diagnoses and those with limited VHA engagement. Without those exclusions, prevalence was slightly higher in both groups (46.1% vs. 24.3%, respectively; prevalence ratio: 1.90). Despite increased prevalence of exposure to military sexual trauma (MST; MSO = 20.7%; non-MSO = 8.3%) and double "likely PTSD" among MSO veterans, they were less likely to have a service-connected PTSD disability than their matched non-MSO (MSO = 78.1%; non-MSO = 87.6%) comparators. Conclusions: VHA-using veterans with MSO were twice as likely to have "likely PTSD" and exposure to MST than veterans with non-MSO. Veterans with MSO were less likely to be service connected for PTSD than non-MSO counterparts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

1079 Is PTSD In Young Women Associated With Rem Sleep Abnormalities?

Abstract Introduction The increase in violence against young women has a high impact on the prevalence of Posttraumatic stress disorder (PTSD). The lifetime prevalence of PTSD is twice as high in women. However, most studies assessing sleep disturbances in PTSD were conducted predominantly in male samples and combat veterans. Objective: To analyze the sleep of young women with and without PTSD. Hypothesis: Women with PTSD have worse sleep quality, higher arousability, and higher muscle activity during REM sleep. Methods Case-controlled study with young women. Seventy-four women who suffered sexual assault and developed PTSD (DSM-5); and 64 women from the community without PTSD. Women were recruited from the PTSD outpatient clinic (Universidade Federal de São Paulo, Brazil).Clinician-Administered Posttraumatic Stress Scale (CAPS 5), Beck Depression and Anxiety Inventories (BDI) (BAI), full in-lab Polysomnography (PSG), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Índex (PSQI), Fatigue Impact Scale (FIS), and Insomnia Severity Índex (ISI) were applied to all participants. Analysis of variance, regression models, and general linear modeling were used. Results Patients mean age was 28 vs 24 for the control group (p=0.004). CAPS mean score in PTSD-group was 42.5±9.1. BDI, BAI, FIS, PSQI, ISI scores were worse in PTSD-group (p<0.05, all). Pittsburgh Sleep Quality Index (PSQI) score was significantly associated with CAPS 5 independently of depression, fatigue, and sleep fragmentation. The PTSD women had lower total sleep time (p= 0.01) and lower REM sleep percentage (p=0.04). However, the control group had higher arousal index (p=.0.01) and had higher muscle activity during REM sleep (p=0.03) than PTSD. Conclusion Women with PTSD had significantly worse score in PSQI, FIS, and ISI. PSQI score was associated with PTSD severity. However, when PSG results are concerned, we found higher sleep fragmentation in the control group. We speculate that women with PTSD may have felt safer and taken care of in the lab, which might explain the difference between objective and subjective measures of sleep quality in PTSD. Support Acknowledgments: FAPESP: Fundação de Apoio à pesquisa de São Paulo, AFIP: Associação Incentivo a Pesquisa

Sex differences in traumatic stress reactivity in rats with and without a history of alcohol drinking

BackgroundAlcohol misuse and post-traumatic stress disorder (PTSD) are highly comorbid, and treatment outcomes are worse in individuals with both conditions. Although more men report experiencing traumatic events than women, the lifetime prevalence of PTSD is twice as high in females. Despite these data trends in humans, preclinical studies of traumatic stress reactivity have been performed almost exclusively in male animals.MethodsThis study was designed to examine sex differences in traumatic stress reactivity in alcohol-naive rats (experiment 1) and rats given intermittent access to 20% ethanol in a 2-bottle choice paradigm for 5 weeks (experiment 2). Animals were exposed to predator odor (bobcat urine) and tested for contextual avoidance 24 h later; unstressed controls were never exposed to predator odor. We evaluated changes in physiological arousal using the acoustic startle response (ASR) test at day 2 post-stress and anxiety-like behavior measured in the elevated plus-maze (EPM) at day 17 post-stress. In experiment 3, time course of corticosterone response was examined in male and female rats following exposure to predator odor stress.ResultsAlcohol-naive males and females exposed to predator odor displayed blunted weight gain 24 h post-stress, but only a subset of stressed animals exhibited avoidance behavior. In alcohol-drinking animals, the proportion of avoiders was higher in males than females, and predator odor exposure increased ASR in males only. Stressed females exhibited blunted ASR relative to unstressed females and stressed males, regardless of alcohol drinking history. Alcohol-experienced females presented lower anxiety-like behavior and higher general activity in the EPM in comparison with alcohol-experienced males. Plasma corticosterone levels were higher in females immediately after predator odor exposure until 60 min post-stress relative to males.ConclusionsWe report robust sex differences in behavioral and endocrine responses to bobcat urine exposure in adult Wistar rats. Also, males with a history of chronic moderate alcohol drinking exhibited increased traumatic stress reactivity relative to alcohol-drinking females. Our findings emphasize the importance of considering sex as a biological variable in the investigation of traumatic stress effects on physiology and behavior.

The Economic Burden of PTSD. A brief review of salient literature

The Economic Burden of PTSD. A brief review of salient literature Studies examine the economic burden of disease can be used to help policy makers set priorities for healthcare research and service provision [1]. These study types seek to quantify the economic impact of disease regardless of its origin or presentation. As such, policy makers are afforded the information allowing them to make decisions across and within therapeutic fields. Health economics deals with the scarcity of resources. Having accurate information about the economic cost of an illness helps policy makers prioritize, eventually leading to the allocation of healthcare resources [2]. Classified as an anxiety disorder, Post- Traumatic Stress Disorder (PTSD) is a condition that can have a significant negative impact on a person’s life [3]. The symptoms of PTSD include flashbacks, intrusive thoughts and nightmares, rumination and avoidance of areas or circumstances (WHO 2017). Figure 1 shows the ICD-10 (WHO 1992) diagnostic criteria for PTSD. Psychological trauma is associated with a number of mental health issues including schizophrenia [4], eating disorders [5] and addictions [6]. In recent years a link between PTSD and physical illnesses such as Type II diabetes [7], cardio-vascular disease [8], certain cancers [9] and fibromyalgia [10] has been noted in the literature. General population studies estimated a prevalence rate of PTSD of 3.6% (WHO 2013). The lifetime prevalence of PTSD in Vietnam War veterans was 16.9% [11] and a study of Canadian service veterans of the Iran war showed a prevalence of 12.9% [12]. UK service personnel returning from Iraq and Afghanistan report PTSD in 4% of cases [13]. In counties that have experienced civil conflict, the rates of PTSD are reported as 8.8% [14]. Given the wide-ranging impact then of PTSD, it is appropriate to examine the economic impact that PTSD has.

PTSD and Trauma-Informed Care in the Long-Term Care Setting

PTSD and Trauma-Informed Care in the Long-Term Care Setting

Impairment of Quality of Life Associated With Lifetime Diagnosis of Post-traumatic Stress Disorder in Women - A National Survey in Italy.

Introduction:The aim of the study was to measure the lifetime prevalence of Post-Traumatic Stress Disorder (PTSD) among women of an Italian community sample, the comorbidity of PTSD with mood and anxiety disorders and the burden attributable to PTSD in worsening the Quality of Life (QoL).Methods:Community survey on a sample of 1961 adult women randomly selected. Tools: psychiatric clinical interview ANTAS partially derived from the SCID-DSM-IV, administered by psychologists or medical doctors; Short Form Health Survey (SF-12); Mood Disorder Questionnaire (MDQ).Results:Lifetime prevalence of PTSD in women was 1.3%, (1.4% in<45 years aged, 1.3% in >44 years aged; p=0.8). In order of risk of comorbidity, PTSD was associated with: Bipolar Spectrum Disorders (MDQ+), Panic Disorders (PD) and Major Depressive Disorder (MDD). People with PTSD showed an SF-12 mean score lower than women of the same sample without PTSD (standardized by gender and age), with a mean difference (attributable burden) of 3.9±0.9 similarly to MDD and Eating Disorders and higher than PD. Among the analyzed nonpsychiatric diseases, Multiple Sclerosis and Carotid Atherosclerosis showed a higher burden in impairing QoL than PTSD; Wilson’s Disease showed a similar burden and Celiac Disease was found less impairing on QoL than PTSD.Conclusion:The attributable burden in worsening women’ perceived QoL due to a lifetime diagnosis of PTSD was found comparable to those caused by MDD, Eating Disorders or by neurological condition such as Wilson’s Disease. The comorbidity of PTSD with Bipolar Spectrum Disorders was remarkable, even further studies are needed to clarify the direction of causality.

The Prevalence of Post-Traumatic Stress Disorder Symptoms in Chronic Pain Patients in a Tertiary Care Setting: A Cross-Sectional Study

There is limited research regarding the prevalence of post-traumatic stress disorder (PTSD) in civilian multidisciplinary pain clinics. Controlled studies have only examined specific patient populations, such as those with motor vehicle accidents, war veterans, work-related injuries, back pain, and headache. The purpose of this study was to estimate the prevalence of PTSD symptoms in patients with chronic pain at a large multidisciplinary pain clinic. Three hundred consecutive new or newly referred patients with a self-reported history of chronic pain were recruited to complete an in-person screen for PTSD symptoms, which included the Brief Trauma Questionnaire and the PTSD Symptom-Scale Self-Report. Two hundred and sixty-five were eligible for the study. Seventy-four (28%) screened positive for PTSD symptoms, a value higher than the lifetime prevalence of PTSD in the general population (6.8%). Those who screened positive for PTSD symptoms were significantly younger (p = 0.007) and had higher levels of pain intensity (p = 0.0005) compared to those who screened negative for PTSD symptoms. The prevalence of PTSD symptoms in our chronic pain population (28%) exceeded the prevalence of PTSD in the general population (7%). Patients with chronic pain who screened positive for PTSD reported higher pain severity and were younger. This emphasizes the need for PTSD screening in the chronic pain population, as early identification and treatment may be effective in reducing the mounting health care costs and disease burden of comorbid chronic pain and PTSD.

Researchers Explore Sleep Problems in Veterans

Researchers Explore Sleep Problems in Veterans

Sex and gender differences in post-traumatic stress disorder: an update

ABSTRACTBackground: Women have a two to three times higher risk of developing post-traumatic stress disorder (PTSD) compared to men. Several factors are involved explaining this difference (Christiansen & Hansen, 2015). Both psychosocial and biological explanations (e.g. oxytocin related) have been suggested and will be reviewed in this paper. To date, we are still behind in gender- and sex-sensitive research and reporting.Prevalence and type of trauma: The lifetime prevalence of PTSD is about 10–12% in women and 5–6% in men. There are similar differences between the sexes for (comorbid) disorders such as major depression and anxiety disorders. PTSD subcluster scores have been found to be increased in women, e.g. for re-experiencing and anxious arousal (Charak et al., 2014). Men and women experience different types of trauma, both in private life and at work (e.g. police officers, Van der Meer et al., 2017), with women being exposed to more high-impact trauma (e.g. sexual trauma) than men, and at a younger age. Trauma early in life has more impact, especially when it involves type II trauma interfering with neurobiological development and personality. Traumatic stress affects different areas of the brains of boys and girls at different ages.Acute phase, stress-coping and psychotherapy: In the acute phase, women generally score higher than men on acute subjective responses, e.g. threat perception, peritraumatic dissociation and known predictors of PTSD. Women handle stressful situations differently and have evolved differentially to support these different behaviours. For instance, women in stressful situations may use a tend-and-befriend response rather than the fight-or-flight response that is often assumed. Emotion-focused, defensive and palliative coping are more prevalent in women, while problem-focused coping is higher in men. Women seek more social support, the lack of it being the most consistent predictor of negative outcome of trauma. Women have been shown to benefit more from psychotherapy then men in the reduction of PTSD symptoms.Psychobiological reactions and effects of oxytocin: Although only 2% of psychobiological research has been conducted in females (mainly rats), sex differences have been shown. Women appear to have a more sensitized hypothalamus–pituitary–axis than men, while men appear to have a sensitized physiological hyperarousal system. PTSD has consistently been associated with amygdala hyperactivity, ventromedial prefrontal cortex (vmPFC) hypoactivity and reduced communication (functional connectivity) between the vmPFC and amygdala, with the lower PFC control over the amygdala providing an explanation for the excessive fear response in PTSD. We hypothesized that the oxytocin system, which is associated with social support, fear and stress responses, was likely to play a sex-specific role in the stress response. In recently traumatized patients, we found that the effects of administration of oxytocin on amygdala reactivity to emotional stimuli depend on stimulus valence and sex (Frijling, 2017). In PTSD patients, we showed sex-specific routes for the effects of single oxytocin administration on the potential to diminish anxiety (fear learning) and fear expression by the amygdala: increased inhibitory control of the vmPFC over the centromedial nucleus in men and fewer excitatory dorsal anterior cingulate cortex projections to the basolateral nucleus in women. So, while our findings add to accumulating evidence that oxytocin administration could potentially enhance treatment response in PTSD, the routes in men and women differ (Frijling, 2017).Gender policy: In summary, all of these sex and gender differences in brain and behaviour together may explain why PTSD is more prevalent in women than in men. Clearly, we should not simplify. There are no male or female stereotypes, but some features are more common in women and others in men. To fully understand the differences, we need more gender- and sex-sensitive research as well as reporting (e.g. see the gender policy of the European Association of Science Editors). In 2016, the European Journal of Psychotraumatology was the first to implement a gender policy (Olff, 2016), i.e. authors are asked to: report the sex of research subjects, justify single-sex studies, discriminate between sex and gender (mostly for human research), analyse how sex or gender impact the results, and discuss sex and gender issues when relevant. This should not only apply to the field of psychotrauma, but deserves a much broader implementation. In doing so, we hope to obtain information that will improve sex- and gender-specific approaches to helping those affected by psychotrauma.

Maternal posttraumatic stress disorder and infant developmental outcomes in a South African birth cohort study.

To investigate the association between maternal posttraumatic stress disorder (PTSD) and infant development in a South African birth cohort. Data from the Drakenstein Child Health Study were analyzed. Maternal psychopathology was assessed using self-report and clinician-administered interviews; and 6-month infant development using the Bayley III Scales of Infant Development. Linear regression analyses explored associations between predictor and outcome variables. Data from 111 mothers and 112 infants (1 set of twins) were included. Most mothers (72%) reported lifetime trauma exposure; the lifetime prevalence of PTSD was 20%. Maternal PTSD was significantly associated with poorer fine motor and adaptive behavior - motor development; the latter remaining significant when adjusted for site, alcohol dependence, and infant head-circumference-for-age z score at birth. Maternal PTSD may be associated with impaired infant neurodevelopment. Further work in low- and middle-income populations may improve early childhood development in this context. (PsycINFO Database Record

Towards a culturally appropriate trauma assessment in a South African Zulu community.

To develop a culture specific screening tool for trauma, and to determine whether it would significantly increase the probability of eliciting traumatic events and associated symptoms when added to a Western diagnostic tool for trauma. A convenience sample of 1 hundred Zulu speaking volunteers was recruited in the North-Eastern KwaZulu-Natal region of South Africa. A demographic questionnaire, the Post Traumatic Stress Disorder (PTSD) section of the Structured Clinical Interview for DSM Disorders, Axis I, Research Version (SCID-I RV), and a Zulu Culture-Specific Trauma Experience Questionnaire (Z-CTEQ) designed for this study were administered to the participants. As measured by the SCID-I RV, the rates of exposure to traumatic events as well as the lifetime prevalence of PTSD were relatively high, at 32% and 24%, respectively. The use of the 10-item Z-CTEQ, when added to the SCID, increased the rate at which traumatic events were elicited by 19.4%. The additional traumatic events elicited were culture-specific in nature and were significantly associated with PTSD (p < .0001). The Z-CTEQ also elicited culture-specific attributions for traumatic events, which could prove beneficial for therapeutic interventions. The Z-CTEQ was found to have acceptable internal reliability, with a Cronbach's alpha of 0.78. The construct and discriminant validity of the Z-CTEQ were supported by several significant correlations between the SCID and the Z-CTEQ and between the additional traumatic events elicited and PTSD. Despite some identified limitations, our findings suggest that the Z-CTEQ can enhance the assessment and management of trauma in the study population. (PsycINFO Database Record

Does the Vulnerability Paradox in PTSD Apply to Women and Men? An Exploratory Study.

Recent research suggests that greater country vulnerability is associated with a decreased, rather than increased, risk of mental health problems. Because societal parameters may have gender-specific implications, our objective was to explore whether the "vulnerability paradox" equally applies to women and men. Lifetime posttraumatic stress disorder (PTSD) prevalence data for women and men were retrieved from 11 population studies (N = 57,031): conducted in Australia, Brazil, Canada, France, Lebanon, Mexico, Netherlands, Portugal, Sweden, Switzerland, and the United States. We tested statistical models with vulnerability, gender, and their interaction as predictors. The average lifetime PTSD prevalence in women was at least twice as high as it was in men and the vulnerability paradox existed in the prevalence data for women and men (R2 = .70). We could not confirm the possibility that gender effects are modified by socioeconomic and cultural country characteristics. Issues of methodology, language, and cultural validity complicate international comparisons. Nevertheless, this international sample points at a parallel paradox: The vulnerability paradox was confirmed for both women and men. The absence of a significant interaction between gender and country vulnerability implies that possible explanations for the paradox at the country-level do not necessarily require gender-driven distinction.

Traumatic stress and psychological functioning in a South African adolescent community sample.

BackgroundTraumatic stress may arise from various incidents often leading to posttraumatic stress disorder (PTSD). The lifetime prevalence of PTSD is estimated at 1% – 2% in Western Europe, 6% – 9% in North America and at just over 10% in countries exposed to long-term violence. In South Africa, the lifetime prevalence for PTSD in the general population is estimated at 2.3%.AimTo examine the prevalence of posttraumatic stress symptomatology and related psychological functioning in a community sample of adolescents.SettingLow-socioeconomic communities in KwaZulu-Natal.MethodsHome interviews with adolescents and their maternal caregivers were used to collect the data using standardised instruments. Adolescents completed the Trauma Symptom Checklist for Children; Children’s Depression Inventory; Children’s Somatization Inventory; and Revised Children’s Manifest Anxiety Scale. The Child Behaviour Checklist was completed by the caregivers. The sample comprised Grade 7 (n = 256) and Grade 10 (n = 68) learners. Sixty-five percent of the sample was female, and ages ranged from 9 to 18 (M = 13.11, s.d. = 1.54).ResultsAlmost 6% of the sample endorsed PTSD and an additional 4% of the participants had clinically significant traumatic stress symptomatology. There was a significant, large, positive correlation between posttraumatic stress and anxiety, and medium positive correlations between posttraumatic stress and depression and somatic symptoms.ConclusionPosttraumatic stress symptomatology can be debilitating, often co-occurring with symptoms of depression, anxiety and somatic complications. This may lead to long-term academic, social and emotional consequences in this vulnerable group.

The contribution of gender-based violence and network trauma to gender differences in Post-Traumatic Stress Disorder.

BackgroundPosttraumatic stress disorder (PTSD) occurs twice as commonly amongst women as men. Two common domains of trauma, network trauma and gender based violence (GBV), may contribute to this gender difference in PTSD rates. We examined data from a nationally representative sample of the Australian population to clarify the characteristics of these two trauma domains in their contributions to PTSD rates in men and women.MethodsWe drew on data from the 2007 Australian National Survey of Mental Health and Well-being to assess gender differences across a comprehensive range of trauma domains, including (1) prevalence of lifetime exposure; (2) identification of an index trauma or DSM-IV Criterion A event; and (3) the likelihood of developing full DSM-IV PTSD symptoms once an index trauma was identified.ResultsMen reported more traumatic events (TEs) overall but women reported twice the prevalence of lifetime PTSD (women, 13.4%; men, 6.3%). Women reported a threefold higher level of exposure to GBV and were seven times more likely to nominate GBV as the index trauma as compared to men. Women were twice more likely than men to identify a network trauma as the index trauma and more likely to meet full PTSD symptoms in relation to that event (women, 20.6%; men, 14.6%).ConclusionWomen are more likely to identify GBV and network trauma as an index trauma. Women’s far greater exposure to GBV contributes to their higher prevalence of PTSD. Women are markedly more likely to develop PTSD when network trauma is identified as the index trauma. Preventing exposure to GBV and providing timely interventions for acute psychological reactions following network trauma may assist in reducing PTSD rates amongst women.