Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the World Health Organization World Mental Health surveys

H. Liu, M.V. Petukhova, N.A. Sampson, S. Aguilar-Gaxiola, J. Alonso, L.H. Andrade, E.J. Bromet, G. De Girolamo, J.M. Haro, H. Hinkov, N. Kawakami, K.C. Koenen, V. Kovess-Masfety, S. Lee, M.E. Medina-Mora, F. Navarro-Mateu, S. O'Neill, M. Piazza, J. Posada-Villa, K.M. Scott & 39 others V. Shahly, D.J. Stein, M. Ten Have, Y. Torres, O. Gureje, A.M. Zaslavsky, R.C. Kessler, A. Al-Hamzawi, M.S. Al-Kaisy, C. Benjet, G. Borges, R. Bruffaerts, B. Bunting, J.M.C. De Almeida, G. Cardoso, S. Chatterji, A.H. Cia, L. Degenhardt, P. De Jonge, K. Demyttenaere, J. Fayyad, S. Florescu, Y. He, C.-Y. Hu, Y. Huang, A.N. Karam, E.G. Karam, A. Kiejna, J.-P. Lepine, D. Levinson, J. McGrath, J. Moskalewicz, B.-E. Pennell, T. Slade, J.C. Stagnaro, M.C. Viana, H. Whiteford, D.R. Williams, B. Wojtyniak

Research output: Contribution to journalReview article

55 Citations (Scopus)
2 Downloads (Pure)

Abstract

Importance: Previous research has documented significant variation in the prevalence of posttraumatic stress disorder (PTSD) depending on the type of traumatic experience (TE) and history of TE exposure, but the relatively small sample sizes in these studies resulted in a number of unresolved basic questions. Objective: To examine disaggregated associations of type of TE history with PTSD in a large cross-national community epidemiologic data set. Design, setting, and participants: TheWorld Health OrganizationWorld Mental Health surveys assessed 29 TE types (lifetime exposure, age at first exposure) with DSM-IV PTSD that was associated with 1 randomly selected TE exposure (the random TE) for each respondent. Surveys were administered in 20 countries (n = 34 676 respondents) from 2001 to 2012. Data were analyzed from October 1, 2015, to September 1, 2016. Main outcomes and measures: Prevalence of PTSD assessed with the Composite International Diagnostic Interview. Results: Among the 34 676 respondents (55.4%[SE, 0.6%] men and 44.6%[SE, 0.6%] women; mean [SE] age, 43.7 [0.2] years), lifetime TE exposure was reported by a weighted 70.3%of respondents (mean [SE] number of exposures, 4.5 [0.04] among respondents with any TE). Weighted (by TE frequency) prevalence of PTSD associated with random TEs was 4.0%. Odds ratios (ORs) of PTSD were elevated for TEs involving sexual violence (2.7; 95%CI, 2.0-3.8) and witnessing atrocities (4.2; 95%CI, 1.0-17.8). Prior exposure to some, but not all, same-type TEs was associated with increased vulnerability (eg, physical assault; OR, 3.2; 95%CI, 1.3-7.9) or resilience (eg, participation in sectarian violence; OR, 0.3; 95%CI, 0.1-0.9) to PTSD after the random TE. The finding of earlier studies that more general history of TE exposure was associated with increased vulnerability to PTSD across the full range of random TE types was replicated, but this generalized vulnerability was limited to prior TEs involving violence, including participation in organized violence (OR, 1.3; 95%CI, 1.0-1.6), experience of physical violence (OR, 1.4; 95%CI, 1.2-1.7), rape (OR, 2.5; 95%CI, 1.7-3.8), and other sexual assault (OR, 1.6; 95%CI, 1.1-2.3). Conclusion and relevance: The World Mental Health survey findings advance understanding of the extent to which PTSD risk varies with the type of TE and history of TE exposure. Previous findings about the elevated PTSD risk associated with TEs involving assaultive violence was refined by showing agreement only for repeated occurrences. Some types of prior TE exposures are associated with increased resilience rather than increased vulnerability, connecting the literature on TE history with the literature on resilience after adversity. These results are valuable in providing an empirical rationale for more focused investigations of these specifications in future studies. © 2017 American Medical Association.
Original languageEnglish
Pages (from-to)270-281
Number of pages12
JournalJAMA Psychiatry
Volume74
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

Fingerprint

Post-Traumatic Stress Disorders
Health Surveys
Diagnostic and Statistical Manual of Mental Disorders
Mental Health
History
Odds Ratio
Violence
Global Health
Rape
Sex Offenses
American Medical Association
Sample Size
Surveys and Questionnaires
Outcome Assessment (Health Care)
Interviews
Health

Keywords

  • adult
  • cross-sectional study
  • cultural factor
  • Diagnostic and Statistical Manual of Mental Disorders
  • exposure to violence
  • female
  • health survey
  • human
  • life event
  • male
  • middle aged
  • psychological resilience
  • psychology
  • statistics and numerical data
  • Stress Disorders, Post-Traumatic
  • world health organization
  • Adult
  • Cross-Cultural Comparison
  • Cross-Sectional Studies
  • Exposure to Violence
  • Female
  • Health Surveys
  • Humans
  • Life Change Events
  • Male
  • Middle Aged
  • Resilience, Psychological
  • World Health Organization

Cite this

Liu, H. ; Petukhova, M.V. ; Sampson, N.A. ; Aguilar-Gaxiola, S. ; Alonso, J. ; Andrade, L.H. ; Bromet, E.J. ; De Girolamo, G. ; Haro, J.M. ; Hinkov, H. ; Kawakami, N. ; Koenen, K.C. ; Kovess-Masfety, V. ; Lee, S. ; Medina-Mora, M.E. ; Navarro-Mateu, F. ; O'Neill, S. ; Piazza, M. ; Posada-Villa, J. ; Scott, K.M. ; Shahly, V. ; Stein, D.J. ; Ten Have, M. ; Torres, Y. ; Gureje, O. ; Zaslavsky, A.M. ; Kessler, R.C. ; Al-Hamzawi, A. ; Al-Kaisy, M.S. ; Benjet, C. ; Borges, G. ; Bruffaerts, R. ; Bunting, B. ; De Almeida, J.M.C. ; Cardoso, G. ; Chatterji, S. ; Cia, A.H. ; Degenhardt, L. ; De Jonge, P. ; Demyttenaere, K. ; Fayyad, J. ; Florescu, S. ; He, Y. ; Hu, C.-Y. ; Huang, Y. ; Karam, A.N. ; Karam, E.G. ; Kiejna, A. ; Lepine, J.-P. ; Levinson, D. ; McGrath, J. ; Moskalewicz, J. ; Pennell, B.-E. ; Slade, T. ; Stagnaro, J.C. ; Viana, M.C. ; Whiteford, H. ; Williams, D.R. ; Wojtyniak, B. / Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the World Health Organization World Mental Health surveys. In: JAMA Psychiatry. 2017 ; Vol. 74, No. 3. pp. 270-281.
@article{4e1cf6218e96454fb54ceaafbbc83ce6,
title = "Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the World Health Organization World Mental Health surveys",
abstract = "Importance: Previous research has documented significant variation in the prevalence of posttraumatic stress disorder (PTSD) depending on the type of traumatic experience (TE) and history of TE exposure, but the relatively small sample sizes in these studies resulted in a number of unresolved basic questions. Objective: To examine disaggregated associations of type of TE history with PTSD in a large cross-national community epidemiologic data set. Design, setting, and participants: TheWorld Health OrganizationWorld Mental Health surveys assessed 29 TE types (lifetime exposure, age at first exposure) with DSM-IV PTSD that was associated with 1 randomly selected TE exposure (the random TE) for each respondent. Surveys were administered in 20 countries (n = 34 676 respondents) from 2001 to 2012. Data were analyzed from October 1, 2015, to September 1, 2016. Main outcomes and measures: Prevalence of PTSD assessed with the Composite International Diagnostic Interview. Results: Among the 34 676 respondents (55.4{\%}[SE, 0.6{\%}] men and 44.6{\%}[SE, 0.6{\%}] women; mean [SE] age, 43.7 [0.2] years), lifetime TE exposure was reported by a weighted 70.3{\%}of respondents (mean [SE] number of exposures, 4.5 [0.04] among respondents with any TE). Weighted (by TE frequency) prevalence of PTSD associated with random TEs was 4.0{\%}. Odds ratios (ORs) of PTSD were elevated for TEs involving sexual violence (2.7; 95{\%}CI, 2.0-3.8) and witnessing atrocities (4.2; 95{\%}CI, 1.0-17.8). Prior exposure to some, but not all, same-type TEs was associated with increased vulnerability (eg, physical assault; OR, 3.2; 95{\%}CI, 1.3-7.9) or resilience (eg, participation in sectarian violence; OR, 0.3; 95{\%}CI, 0.1-0.9) to PTSD after the random TE. The finding of earlier studies that more general history of TE exposure was associated with increased vulnerability to PTSD across the full range of random TE types was replicated, but this generalized vulnerability was limited to prior TEs involving violence, including participation in organized violence (OR, 1.3; 95{\%}CI, 1.0-1.6), experience of physical violence (OR, 1.4; 95{\%}CI, 1.2-1.7), rape (OR, 2.5; 95{\%}CI, 1.7-3.8), and other sexual assault (OR, 1.6; 95{\%}CI, 1.1-2.3). Conclusion and relevance: The World Mental Health survey findings advance understanding of the extent to which PTSD risk varies with the type of TE and history of TE exposure. Previous findings about the elevated PTSD risk associated with TEs involving assaultive violence was refined by showing agreement only for repeated occurrences. Some types of prior TE exposures are associated with increased resilience rather than increased vulnerability, connecting the literature on TE history with the literature on resilience after adversity. These results are valuable in providing an empirical rationale for more focused investigations of these specifications in future studies. {\circledC} 2017 American Medical Association.",
keywords = "adult, cross-sectional study, cultural factor, Diagnostic and Statistical Manual of Mental Disorders, exposure to violence, female, health survey, human, life event, male, middle aged, psychological resilience, psychology, statistics and numerical data, Stress Disorders, Post-Traumatic, world health organization, Adult, Cross-Cultural Comparison, Cross-Sectional Studies, Exposure to Violence, Female, Health Surveys, Humans, Life Change Events, Male, Middle Aged, Resilience, Psychological, World Health Organization",
author = "H. Liu and M.V. Petukhova and N.A. Sampson and S. Aguilar-Gaxiola and J. Alonso and L.H. Andrade and E.J. Bromet and {De Girolamo}, G. and J.M. Haro and H. Hinkov and N. Kawakami and K.C. Koenen and V. Kovess-Masfety and S. Lee and M.E. Medina-Mora and F. Navarro-Mateu and S. O'Neill and M. Piazza and J. Posada-Villa and K.M. Scott and V. Shahly and D.J. Stein and {Ten Have}, M. and Y. Torres and O. Gureje and A.M. Zaslavsky and R.C. Kessler and A. Al-Hamzawi and M.S. Al-Kaisy and C. Benjet and G. Borges and R. Bruffaerts and B. Bunting and {De Almeida}, J.M.C. and G. Cardoso and S. Chatterji and A.H. Cia and L. Degenhardt and {De Jonge}, P. and K. Demyttenaere and J. Fayyad and S. Florescu and Y. He and C.-Y. Hu and Y. Huang and A.N. Karam and E.G. Karam and A. Kiejna and J.-P. Lepine and D. Levinson and J. McGrath and J. Moskalewicz and B.-E. Pennell and T. Slade and J.C. Stagnaro and M.C. Viana and H. Whiteford and D.R. Williams and B. Wojtyniak",
year = "2017",
month = "3",
day = "1",
doi = "10.1001/jamapsychiatry.2016.3783",
language = "English",
volume = "74",
pages = "270--281",
journal = "JAMA Psychiatry",
issn = "2168-622X",
publisher = "Ama American Medical Association",
number = "3",

}

Liu, H, Petukhova, MV, Sampson, NA, Aguilar-Gaxiola, S, Alonso, J, Andrade, LH, Bromet, EJ, De Girolamo, G, Haro, JM, Hinkov, H, Kawakami, N, Koenen, KC, Kovess-Masfety, V, Lee, S, Medina-Mora, ME, Navarro-Mateu, F, O'Neill, S, Piazza, M, Posada-Villa, J, Scott, KM, Shahly, V, Stein, DJ, Ten Have, M, Torres, Y, Gureje, O, Zaslavsky, AM, Kessler, RC, Al-Hamzawi, A, Al-Kaisy, MS, Benjet, C, Borges, G, Bruffaerts, R, Bunting, B, De Almeida, JMC, Cardoso, G, Chatterji, S, Cia, AH, Degenhardt, L, De Jonge, P, Demyttenaere, K, Fayyad, J, Florescu, S, He, Y, Hu, C-Y, Huang, Y, Karam, AN, Karam, EG, Kiejna, A, Lepine, J-P, Levinson, D, McGrath, J, Moskalewicz, J, Pennell, B-E, Slade, T, Stagnaro, JC, Viana, MC, Whiteford, H, Williams, DR & Wojtyniak, B 2017, 'Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the World Health Organization World Mental Health surveys', JAMA Psychiatry, vol. 74, no. 3, pp. 270-281. https://doi.org/10.1001/jamapsychiatry.2016.3783

Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the World Health Organization World Mental Health surveys. / Liu, H.; Petukhova, M.V.; Sampson, N.A.; Aguilar-Gaxiola, S.; Alonso, J.; Andrade, L.H.; Bromet, E.J.; De Girolamo, G.; Haro, J.M.; Hinkov, H.; Kawakami, N.; Koenen, K.C.; Kovess-Masfety, V.; Lee, S.; Medina-Mora, M.E.; Navarro-Mateu, F.; O'Neill, S.; Piazza, M.; Posada-Villa, J.; Scott, K.M.; Shahly, V.; Stein, D.J.; Ten Have, M.; Torres, Y.; Gureje, O.; Zaslavsky, A.M.; Kessler, R.C.; Al-Hamzawi, A.; Al-Kaisy, M.S.; Benjet, C.; Borges, G.; Bruffaerts, R.; Bunting, B.; De Almeida, J.M.C.; Cardoso, G.; Chatterji, S.; Cia, A.H.; Degenhardt, L.; De Jonge, P.; Demyttenaere, K.; Fayyad, J.; Florescu, S.; He, Y.; Hu, C.-Y.; Huang, Y.; Karam, A.N.; Karam, E.G.; Kiejna, A.; Lepine, J.-P.; Levinson, D.; McGrath, J.; Moskalewicz, J.; Pennell, B.-E.; Slade, T.; Stagnaro, J.C.; Viana, M.C.; Whiteford, H.; Williams, D.R.; Wojtyniak, B.

In: JAMA Psychiatry, Vol. 74, No. 3, 01.03.2017, p. 270-281.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the World Health Organization World Mental Health surveys

AU - Liu, H.

AU - Petukhova, M.V.

AU - Sampson, N.A.

AU - Aguilar-Gaxiola, S.

AU - Alonso, J.

AU - Andrade, L.H.

AU - Bromet, E.J.

AU - De Girolamo, G.

AU - Haro, J.M.

AU - Hinkov, H.

AU - Kawakami, N.

AU - Koenen, K.C.

AU - Kovess-Masfety, V.

AU - Lee, S.

AU - Medina-Mora, M.E.

AU - Navarro-Mateu, F.

AU - O'Neill, S.

AU - Piazza, M.

AU - Posada-Villa, J.

AU - Scott, K.M.

AU - Shahly, V.

AU - Stein, D.J.

AU - Ten Have, M.

AU - Torres, Y.

AU - Gureje, O.

AU - Zaslavsky, A.M.

AU - Kessler, R.C.

AU - Al-Hamzawi, A.

AU - Al-Kaisy, M.S.

AU - Benjet, C.

AU - Borges, G.

AU - Bruffaerts, R.

AU - Bunting, B.

AU - De Almeida, J.M.C.

AU - Cardoso, G.

AU - Chatterji, S.

AU - Cia, A.H.

AU - Degenhardt, L.

AU - De Jonge, P.

AU - Demyttenaere, K.

AU - Fayyad, J.

AU - Florescu, S.

AU - He, Y.

AU - Hu, C.-Y.

AU - Huang, Y.

AU - Karam, A.N.

AU - Karam, E.G.

AU - Kiejna, A.

AU - Lepine, J.-P.

AU - Levinson, D.

AU - McGrath, J.

AU - Moskalewicz, J.

AU - Pennell, B.-E.

AU - Slade, T.

AU - Stagnaro, J.C.

AU - Viana, M.C.

AU - Whiteford, H.

AU - Williams, D.R.

AU - Wojtyniak, B.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Importance: Previous research has documented significant variation in the prevalence of posttraumatic stress disorder (PTSD) depending on the type of traumatic experience (TE) and history of TE exposure, but the relatively small sample sizes in these studies resulted in a number of unresolved basic questions. Objective: To examine disaggregated associations of type of TE history with PTSD in a large cross-national community epidemiologic data set. Design, setting, and participants: TheWorld Health OrganizationWorld Mental Health surveys assessed 29 TE types (lifetime exposure, age at first exposure) with DSM-IV PTSD that was associated with 1 randomly selected TE exposure (the random TE) for each respondent. Surveys were administered in 20 countries (n = 34 676 respondents) from 2001 to 2012. Data were analyzed from October 1, 2015, to September 1, 2016. Main outcomes and measures: Prevalence of PTSD assessed with the Composite International Diagnostic Interview. Results: Among the 34 676 respondents (55.4%[SE, 0.6%] men and 44.6%[SE, 0.6%] women; mean [SE] age, 43.7 [0.2] years), lifetime TE exposure was reported by a weighted 70.3%of respondents (mean [SE] number of exposures, 4.5 [0.04] among respondents with any TE). Weighted (by TE frequency) prevalence of PTSD associated with random TEs was 4.0%. Odds ratios (ORs) of PTSD were elevated for TEs involving sexual violence (2.7; 95%CI, 2.0-3.8) and witnessing atrocities (4.2; 95%CI, 1.0-17.8). Prior exposure to some, but not all, same-type TEs was associated with increased vulnerability (eg, physical assault; OR, 3.2; 95%CI, 1.3-7.9) or resilience (eg, participation in sectarian violence; OR, 0.3; 95%CI, 0.1-0.9) to PTSD after the random TE. The finding of earlier studies that more general history of TE exposure was associated with increased vulnerability to PTSD across the full range of random TE types was replicated, but this generalized vulnerability was limited to prior TEs involving violence, including participation in organized violence (OR, 1.3; 95%CI, 1.0-1.6), experience of physical violence (OR, 1.4; 95%CI, 1.2-1.7), rape (OR, 2.5; 95%CI, 1.7-3.8), and other sexual assault (OR, 1.6; 95%CI, 1.1-2.3). Conclusion and relevance: The World Mental Health survey findings advance understanding of the extent to which PTSD risk varies with the type of TE and history of TE exposure. Previous findings about the elevated PTSD risk associated with TEs involving assaultive violence was refined by showing agreement only for repeated occurrences. Some types of prior TE exposures are associated with increased resilience rather than increased vulnerability, connecting the literature on TE history with the literature on resilience after adversity. These results are valuable in providing an empirical rationale for more focused investigations of these specifications in future studies. © 2017 American Medical Association.

AB - Importance: Previous research has documented significant variation in the prevalence of posttraumatic stress disorder (PTSD) depending on the type of traumatic experience (TE) and history of TE exposure, but the relatively small sample sizes in these studies resulted in a number of unresolved basic questions. Objective: To examine disaggregated associations of type of TE history with PTSD in a large cross-national community epidemiologic data set. Design, setting, and participants: TheWorld Health OrganizationWorld Mental Health surveys assessed 29 TE types (lifetime exposure, age at first exposure) with DSM-IV PTSD that was associated with 1 randomly selected TE exposure (the random TE) for each respondent. Surveys were administered in 20 countries (n = 34 676 respondents) from 2001 to 2012. Data were analyzed from October 1, 2015, to September 1, 2016. Main outcomes and measures: Prevalence of PTSD assessed with the Composite International Diagnostic Interview. Results: Among the 34 676 respondents (55.4%[SE, 0.6%] men and 44.6%[SE, 0.6%] women; mean [SE] age, 43.7 [0.2] years), lifetime TE exposure was reported by a weighted 70.3%of respondents (mean [SE] number of exposures, 4.5 [0.04] among respondents with any TE). Weighted (by TE frequency) prevalence of PTSD associated with random TEs was 4.0%. Odds ratios (ORs) of PTSD were elevated for TEs involving sexual violence (2.7; 95%CI, 2.0-3.8) and witnessing atrocities (4.2; 95%CI, 1.0-17.8). Prior exposure to some, but not all, same-type TEs was associated with increased vulnerability (eg, physical assault; OR, 3.2; 95%CI, 1.3-7.9) or resilience (eg, participation in sectarian violence; OR, 0.3; 95%CI, 0.1-0.9) to PTSD after the random TE. The finding of earlier studies that more general history of TE exposure was associated with increased vulnerability to PTSD across the full range of random TE types was replicated, but this generalized vulnerability was limited to prior TEs involving violence, including participation in organized violence (OR, 1.3; 95%CI, 1.0-1.6), experience of physical violence (OR, 1.4; 95%CI, 1.2-1.7), rape (OR, 2.5; 95%CI, 1.7-3.8), and other sexual assault (OR, 1.6; 95%CI, 1.1-2.3). Conclusion and relevance: The World Mental Health survey findings advance understanding of the extent to which PTSD risk varies with the type of TE and history of TE exposure. Previous findings about the elevated PTSD risk associated with TEs involving assaultive violence was refined by showing agreement only for repeated occurrences. Some types of prior TE exposures are associated with increased resilience rather than increased vulnerability, connecting the literature on TE history with the literature on resilience after adversity. These results are valuable in providing an empirical rationale for more focused investigations of these specifications in future studies. © 2017 American Medical Association.

KW - adult

KW - cross-sectional study

KW - cultural factor

KW - Diagnostic and Statistical Manual of Mental Disorders

KW - exposure to violence

KW - female

KW - health survey

KW - human

KW - life event

KW - male

KW - middle aged

KW - psychological resilience

KW - psychology

KW - statistics and numerical data

KW - Stress Disorders, Post-Traumatic

KW - world health organization

KW - Adult

KW - Cross-Cultural Comparison

KW - Cross-Sectional Studies

KW - Exposure to Violence

KW - Female

KW - Health Surveys

KW - Humans

KW - Life Change Events

KW - Male

KW - Middle Aged

KW - Resilience, Psychological

KW - World Health Organization

U2 - 10.1001/jamapsychiatry.2016.3783

DO - 10.1001/jamapsychiatry.2016.3783

M3 - Review article

VL - 74

SP - 270

EP - 281

JO - JAMA Psychiatry

JF - JAMA Psychiatry

SN - 2168-622X

IS - 3

ER -