Hostname: page-component-7c8c6479df-8mjnm Total loading time: 0 Render date: 2024-03-29T07:44:59.969Z Has data issue: false hasContentIssue false

Association between traumatic events and post-traumatic stress disorder: results from the ESEMeD-Spain study

Published online by Cambridge University Press:  25 February 2014

B. Olaya*
Affiliation:
Ciber en Salud Mental (CIBERSAM), Madrid, Spain Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
J. Alonso
Affiliation:
Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain Department of Experimental and Health Sciences (CEXS), Universitat Pompeu Fabra (UPF), Barcelona, Spain
L. Atwoli
Affiliation:
Department of Mental Health, School of Medicine, Moi University College of Health Sciences, Eldoret, Kenya Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
G. Vilagut
Affiliation:
Health Services Research Unit, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Spain
J. M. Haro
Affiliation:
Ciber en Salud Mental (CIBERSAM), Madrid, Spain Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain Universitat de Barcelona, Barcelona, Spain
*
*Address for correspondence: Dr Beatriz Olaya, Unitat de Recerca i Desenvolupament, Parc Sanitari Sant Joan de Déu-CIBERSAM, Sant Boi de Llobregat, Spain. (Email: beatriz.olaya@pssjd.org)

Abstract

Background.

The relative importance of traumatic events (TEs) in accounting for the social burden of post-traumatic stress disorder (PTSD) could vary according to cross-cultural factors. In that sense, no such studies have yet been conducted in the Spanish general population. The present study aims to determine the epidemiology of trauma and PTSD in a Spanish community sample using the randomly selected TEs method.

Methods.

The European Study of the Epidemiology of Mental Disorders (ESEMeD)-Spain is a cross-sectional household survey of a representative sample of adult population. Lifetime prevalence of self-reported TEs and lifetime and 12-month prevalence of PTSD were evaluated using the World Health Organization (WHO) Composite International Diagnostic Interview. Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE.

Results.

Road accident was the most commonly self-reported TE (14.1%). Sexual assault had the highest conditional risk of PTSD (16.5%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (36.4% of all cases) and sexual assault (17.2%). Being female and having a low educational level were associated with low risk of overall TE exposure and being previously married was related to higher risk. Being female was related to high risk of PTSD after experiencing a TE.

Conclusions.

Having an accident is commonly reported among Spanish adults, but two TE are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahmed, AS (2007). Post-traumatic stress disorder, resilience and vulnerability. Advances in Psychiatric Treatment 13, 369375.CrossRefGoogle Scholar
Alonso, J, Angermeyer, MC, Bernert, S, Bruffaerts, R, Brugha, TS, Bryson, H, de Girolamo, G, Graaf, R, Demyttenaere, K, Gasquet, I, Haro, JM, Katz, SJ, Kessler, RC, Kovess, V, Lepine, JP, Ormel, J, Polidori, G, Russo, LJ, Vilagut, G, Almansa, J, Arbabzadeh-Bouchez, S, Autonell, J, Bernal, M, Buist-Bouwman, MA, Codony, M, Domingo-Salvany, A, Ferrer, M, Joo, SS, Martinez-Alonso, M, Matschinger, H, Mazzi, F, Morgan, Z, Morosini, P, Palacin, C, Romera, B, Taub, N, Vollebergh, WA, ESEMeD/MHEDEA 2000 Investigators, European Study of the Epidemiology of Mental Disorders (ESEMeD) Project (2004). Sampling and methods of the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatrica Scandinavica. Supplementum 420, 820.Google Scholar
Alonso, J, Lepine, JP, ESEMeD/MHEDEA 2000 Scientific Committee (2007). Overview of key data from the European Study of the Epidemiology of Mental Disorders (ESEMeD). Journal of Clinical Psychiatry 68(Suppl. 2), 39.Google Scholar
Amaddeo, F, Tansella, M (2012). Mental health, natural and man-made disasters: lessons learnt and future needs. Epidemiology and Psychiatric Sciences 21, 15.CrossRefGoogle Scholar
Baker, CK, Norris, FH, Diaz, DM, Perilla, JL, Murphy, AD, Hill, EG (2005). Violence and PTSD in Mexico: gender and regional differences. Social Psychiatry and Psychiatric Epidemiology 40, 519528.Google Scholar
Breslau, N, Davis, G (1992). Posttraumatic stress disorder in an urban population of young adults: risk factors for chronicity. American Journal of Psychiatry 152, 529539.Google Scholar
Breslau, N, Kessler, RC (2001). The stressor criterion in DSM-IV posttraumatic stress disorder: an empirical investigation. Biological Psychiatry 50, 699704.Google Scholar
Breslau, N, Kessler, RC, Chilcoat, HD, Schultz, LR, Davis, GC, Andreski, P (1998). Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Archives of General Psychiatry 55, 626632.CrossRefGoogle ScholarPubMed
Breslau, N, Chilcoat, HD, Kessler, RC, Davis, GC (1999). Previous exposure to trauma and PTSD effects of subsequent trauma: results from the Detroit Area Survey of Trauma. American Journal of Psychiatry 156, 902907.Google Scholar
Breslau, N, Peterson, EL, Poisson, LM, Schultz, LR, Lucia, VC (2004). Estimating post-traumatic stress disorder in the community: lifetime perspective and the impact of typical traumatic events. Psychological Medicine 34, 889898.Google Scholar
Brewin, CR, Andrews, B, Valentine, JD (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology 68, 748766.CrossRefGoogle ScholarPubMed
Brom, D, Kleber, RJ, Hofman, MC (1993). Victims of traffic accidents: incidence and prevention of post-traumatic stress disorder. Journal of Clinical Psychology 49, 131140.3.0.CO;2-2>CrossRefGoogle ScholarPubMed
Bronner, MB, Peek, N, Vries, M, Bronner, AE, Last, BF, Grootenhuis, MA (2009). A community-based survey of posttraumatic stress disorder in the Netherlands. Journal of Traumatic Stress 22, 7478.CrossRefGoogle ScholarPubMed
Carey, PD, Stein, DJ, Zungu-Dirwayi, N, Seedat, S (2003). Trauma and posttraumatic stress disorder in an urban Xhosa primary care population: prevalence, comorbidity, and service use patterns. Journal of Nervous and Mental Disease 191, 230236.CrossRefGoogle Scholar
Creamer, M, Burgess, P, McFarlane, AC (2001). Post-traumatic stress disorder: findings from the Australian National Survey of Mental Health and Well-being. Psychological Medicine 31, 12371247.CrossRefGoogle ScholarPubMed
Cusack, K, Falsetti, S, Arellano, M (2003). Gender considerations in psychometric assessment. In Gender and PTSD (ed. Kimerling, R, Ouimette, P and Wolfe, J), pp. 150176. Guilford Press: New York.Google Scholar
Darves-Bornoz, JM, Alonso, J, de Girolamo, G, de Graaf, R, Haro, JM, Kovess-Masfety, V, Lepine, JP, Nachbaur, G, Negre-Pages, L, Vilagut, G, Gasquet, I, ESEMeD/MHEDEA 2000 Investigators (2008). Main traumatic events in Europe: PTSD in the European study of the epidemiology of mental disorders survey. Journal of Traumatic Stress 21, 455462.CrossRefGoogle ScholarPubMed
Feldner, MT, Monson, CM, Friedman, MJ (2007). A critical analysis of approaches to targeted PTSD prevention: current status and theoretically derived future directions. Behavior Modification 31, 80116.CrossRefGoogle ScholarPubMed
Frans, O, Rimmo, PA, Aberg, L, Fredrikson, M (2005). Trauma exposure and post-traumatic stress disorder in the general population. Acta Psychiatrica Scandinavica 111, 291299.Google Scholar
Hardt, J, Rutter, M (2004). Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. Journal of Child Psychology and Psychiatry, and Allied Disciplines 45, 260273.CrossRefGoogle ScholarPubMed
Haro, JM, Palacin, C, Vilagut, G, Romera, B, Codony, M, Autonell, J, Ferrer, M, Ramos, J, Kessler, R, Alonso, J (2003). Epidemiology of mental disorders in Spain: methods and participation in the ESEMeD-Spain project. Actas Españolas de Psiquiatria 31, 182191.Google Scholar
Haro, JM, Arbabzadeh-Bouchez, S, Brugha, TS, de Girolamo, G, Guyer, ME, Jin, R, Lepine, JP, Mazzi, F, Reneses, B, Vilagut, G, Sampson, NA, Kessler, RC (2006). Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys. International Journal of Methods in Psychiatric Research 15, 167180.CrossRefGoogle ScholarPubMed
Hatch, SL, Dohrenwend, BP (2007). Distribution of traumatic and other stressful life events by race/ethnicity, gender, SES and age: a review of the research. American Journal of Community Psychology 40, 313332.CrossRefGoogle Scholar
Hepp, U, Gamma, A, Milos, G, Eich, D, Ajdacic-Gross, V, Rössler, W, Angst, J, Schnyder, U (2006). Inconsistency in reporting potentially traumatic events. British Journal of Psychiatry 188, 278283.Google Scholar
Hinton, DE, Lewis-Fernandez, R (2011). The cross-cultural validity of posttraumatic stress disorder: implications for DSM-5. Depression and Anxiety 28, 783801.CrossRefGoogle ScholarPubMed
Holbrook, TL, Hoyt, DB, Stein, MB, Sieber, WJ (2002). Gender differences in long-term posttraumatic stress disorder outcomes after major trauma: women are at higher risk of adverse outcomes than men. Journal of Trauma 53, 882888.Google Scholar
Hollifield, M, Warner, TD, Jenkins, J, Sinclair-Lian, N, Krakow, B, Eckert, V, Karadaghi, P, Westermeyer, J (2006). Assessing war trauma in refugees: properties of the Comprehensive Trauma Inventory-104. Journal of Traumatic Stress 19, 527540.Google Scholar
Jeon, W, Hong, C, Lee, C, Kim, DK, Han, M, Min, S (2005). Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea. Journal of Traumatic Stress 18, 147154.Google Scholar
Kessler, RC, Ustun, TB (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93121.CrossRefGoogle ScholarPubMed
Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, CB (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 10481060.CrossRefGoogle ScholarPubMed
Kessler, RC, Chiu, WT, Demler, O, Merikangas, KR, Walters, EE (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62, 617627.CrossRefGoogle ScholarPubMed
López-Ibor, JJ (1942). Neurosis de guerra. Científico-Técnica: Madrid.Google Scholar
Mladovsky, P, Allin, S, Masseria, C, Hernández-Quevedo, C, McDaid, D, Mossialos, E (2009). Health in the European Union: Trends and Analysis. World Health Organization on behalf of the European Observatory on Health Systems and Policies: Copenhagen.Google Scholar
Norris, FH, Foster, JD, Weisshaar, DL (2003 a). The epidemiology of sex differences in PTSD across developmental, societal, and research contexts. In Gender and PTSD (ed. Kimerling, R, Ouimette, P and Wolfe, J), pp. 342. Guilford Press: New York.Google Scholar
Norris, FH, Murphy, AD, Baker, CK, Perilla, JL, Rodriguez, FG, Rodriguez Jde, J (2003 b). Epidemiology of trauma and posttraumatic stress disorder in Mexico. Journal of Abnormal Psychology 112, 646656.Google Scholar
Perkonigg, A, Kessler, RC, Storz, S, Wittchen, HU (2000). Traumatic events and post-traumatic stress disorder in the community: prevalence, risk factors and comorbidity. Acta Psychiatrica Scandinavica 101, 4659.CrossRefGoogle ScholarPubMed
Pimlott-Kubiak, S, Cortina, L (2003). Gender, victimization, and outcomes: reconceptualizing risk. Journal of Consulting and Clinical Psychology 71, 528539.Google Scholar
Pinto-Meza, A, Haro, JM, Palacin, C, Torres, JV, Ochoa, S, Vilagut, G, Martinez-Alonso, M, Codony, M, Alonso, J (2007). The impact of mood and anxiety disorders, and physical chronic conditions in the quality of life of general population of Spain. Results of the ESEMeD-Spain study. Actas Españolas de Psiquiatria 35(Suppl 2), 1220.Google ScholarPubMed
Porter, S, Peace, KA (2007). The scars of memory: a prospective, longitudinal investigation of the consistency of traumatic and positive emotional memories in adulthood. Psychological Science 18, 435441.CrossRefGoogle ScholarPubMed
Resnick, HS, Kilpatrick, DG, Dansky, BS, Saunders, BE, Best, CL (1993). Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. Journal of Consulting and Clinical Psychology 61, 984991.Google Scholar
Rothschild, B (2000). The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. Norton: New York.Google Scholar
Sabin, M, Lopes Cardozo, B, Nackerud, L, Kaiser, R, Varese, L (2003). Factors associated with poor mental health among Guatemalan refugees living in Mexico 20 years after civil conflict. Journal of the American Medical Association 290, 635642.Google Scholar
Saxe, G, Wolfe, J (1999). Gender and Posttraumatic Stress Disorder. In Posttraumatic Stress Disorder (ed. Saigh, P and Bremner, J), pp. 160179. Allyn and Bacon: Boston.Google Scholar
Sederer, LI (2012). Are human disasters different? Epidemiology and Psychiatric Sciences 21, 2325.Google Scholar
Stein, MB, Walker, JR, Forde, DR (2000). Gender differences in susceptibility to posttraumatic stress disorder. Behaviour Research and Therapy 38, 619628.Google Scholar
SUDAAN 9.0.2 (2005). Professional Software for Survey Data Analysis. Research Triangle Institute: Research Triangle Parc, NC.Google Scholar
Villasante, O (2010). War neurosis during the Spanish Civil War (1936–39). History of Psychiatry 21, 424435.CrossRefGoogle ScholarPubMed
Weathers, FW, Keane, TM (2007). The Criterion A problem revisited: controversies and challenges in defining and measuring psychological trauma. Journal of Traumatic Stress 20, 107121.Google Scholar
Wolter, KM (1985). Introduction to Variance Estimation. Springer-Verlag: New York.Google Scholar
World Health Organization (2007). Rape: How women, the community and the health sector respond. Retrieved 18 February 2013 from http://www.svri.org/rape.pdf.Google Scholar