WHO Analysis Expands on Trauma, PTSD Association (Source, Liu H, et al. JAMA Psychiatry, 04.01.2017)
Previous traumatic experiences were generally associated with PTSD. This is the analysis result of a large cross-national community sample which indicated that generalized risk was limited to previous exposure to violence and sexual assault.
Howard Liu of Harvard Medical School stated that PTSD prevalence is highest for (traumatic experiences) involving interpersonal violence. He further stressed that some research suggests that traumatic experience is a risk factor for subsequent PTSD, with prior (traumatic experience) involving violence. On the other hand, these studies did not examine prior (traumatic experience) comprehensively. This makes it unclear whether the special importance of (traumatic experience) involving interpersonal violence is limited to personal experience of this violence or includes witnessing extreme violence. Furthermore, it is also a question whether repeated exposure to similar (traumatic experience) is of special importance.
Researchers administered WHO World Mental Health surveys that assessed 29 types of traumatic experiences and DSM-IV PTSD in 20 countries from 2001 to 2012 to determine associations of type of traumatic experience history with PTSD.
Risk for PTSD was higher among participants with traumatic experiences involving sexual violence (OR = 2.7; 95% CI, 2-3.8) and witnessing atrocities (OR = 4.2; 95% CI, 1-17.8).
Prior lifetime group-level, same-type traumatic experiences was significantly associated with PTSD (P = .01).
Prior exposure to physical violence in the presence of a prior same-type traumatic experience (OR = 3.2; 95% CI, 1.3-7.9) was associated with increased risk for PTSD, while participation in organized violence in the presence of a prior same-type traumatic experience (OR = 0.2; 95% CI, 0.1-0.8) was associated with decreased risk.
Current findings replicated previous findings that associated increased risk for PTSD with a general history of traumatic experiences, however; generalized risk was limited to prior traumatic experiences involving violence, including participation in organized violence (OR = 1.3; 95% CI, 1-1.6), 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).
Researchers concluded that results are valuable in advancing understanding of complex ways in which specific traumatic experiences and histories are associated with PTSD. There are questions unresolved about casual pathways and mechanisms but this contributes in providing a foundation for more focused investigations.