A Second Look at Prior Trauma and the Posttraumatic Stress Disorder Effects of Subsequent Trauma

Breslau, Naomi; Peterson, Edward L.; Schultz, Lonni

doi:10.1001/archpsyc.65.4.431

Cited by 255 publications

(223 citation statements)

References 59 publications

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“…The literature suggests that people with a history of prior trauma exposure are more likely than others to develop PTSD after exposure to subsequent traumas (Breslau, Peterson, & Shultz, 2008; Caramanica et al, 2015). Consistent with this evidence, a previous WMH report found that the vast majority of prior trauma types are significantly and positively associated with subsequent trauma exposure (Benjet et al, 2016).…”

Section: Resultsmentioning

confidence: 99%

Trauma and PTSD in the WHO World Mental Health Surveys

Kessler

Aguilar‐Gaxiola

Alonso

et al. 2017

European Journal of Psychotraumatology

976

720

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Background: Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their ‘worst.’ Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD. Method: WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the ‘worst’ lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview. Results: In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk. Conclusions: Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits within months after onset, mean symptom duration is considerably longer than previously recognized.

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Section: Resultsmentioning

confidence: 99%

Trauma and PTSD in the WHO World Mental Health Surveys

Kessler

Aguilar‐Gaxiola

Alonso

et al. 2017

European Journal of Psychotraumatology

976

720

View full text Add to dashboard Cite

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“…31 PTSD was more common in women at baseline, and given that both being female and having a prior episode of PTSD increases the risk of developing PTSD in response to a new traumatic event, higher rates of reexposure for women are likely to translate to much greater risk of PTSD in women injecting drug users. 6,9 Men and women were equally likely to report being physically assaulted or witnessing a physical assault, which translates to an exceptionally high rate of violence for women since community studies generally show that men are at considerably higher risk for violence than women. 32 Male and female injecting drug users may place themselves at increased risk for traumatic events via criminal activity and exposure to dangerous people and situations; 33,34 the higher rates of experiencing and witnessing physical assaults (compared to community samples) support this interpretation.…”

Section: Discussion High Rates Of Traumatic Event Re-exposurementioning

confidence: 99%

“…The few studies using general community-based samples show a 3-to 5-year re-exposure rate of 20-40%, with no gender differences. 6,7 The clinical relevance of these data is clear from studies that show that traumatic event reexposure alone or followed by PTSD increases the risk of further psychiatric impairment, including both PTSD and drug use. [6][7][8] There is good reason to believe that urban drug users experience a considerable amount of traumatic event re-exposure.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11][12] In addition to these risk factors, past trauma exposure alone, which is present in nearly all drug users, further increases the risk for re-exposure. 6,13,14 For example, a history of physical or sexual assault is associated with a 2-to 6-fold increase in risk for re-exposure to another violent event. 15 That women are more likely to experience re-exposure to sexual and some other violent assaults than men 7 suggests that within drug user populations they might be at higher risk for traumatic event re-exposure.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Traumatic Event Re-exposure in Injecting Drug Users

et al. 2011

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Drug users have very high rates of lifetime exposure to traumatic events, leading to significant psychiatric complications. In spite of the high rate of lifetime exposure, very little is known about the rate of ongoing re-exposure to new traumatic events in drug users. We investigated the rate of traumatic event re-exposure in male and female injecting drug users using syringe exchange services in Baltimore (N=197). Participants were assessed monthly for traumatic event re-exposure for 16 months. Averaged over the entire follow-up period, 27% of participants were re-exposed to a traumatic event each month and 72% were re-exposed over the 16-month study period. Women were over twice as likely to report any traumatic event re-exposure as men (adjusted odds ratio [AOR]=2.48; 95% CI=1.54-3.99), with the specific events of lifethreatening illness, death of a loved one, and injury or illness of a loved one being more common in women than men. Traumatic event re-exposure occurs far more often than previously reported, with women injecting drug users at the highest risk. Reassessment of traumatic events may help to identify people most in need and encourage entry into treatment.

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“…It is likely that the occurrence of different traumatic events exceeds the person's coping resources, although it is also possible that the susceptibility to respond to stressful or traumatic events with TI is also relevant. In this regard, research on the association between subsequent exposure to new traumatic events and the development of PTSD suggests that the susceptibility to respond pathologically to traumatic events (Breslau, Peterson, & Edward, 2010;Breslau, Peterson, & Schultz, 2008) and the frequency of these events (Cougle, Resnick, & Kilpatrick, 2009;Sledjeski, Speisman, & Dierker, 2010) are both important factors.…”

Section: Discussionmentioning

confidence: 99%

Predictores de la inmovilidad tónica ante eventos traumáticos

2015

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Título: Predictores de la inmovilidad tónica ante eventos traumáticos. Resumen: La inmovilidad tónica (IT) es una posible reacción ante el peligro que es facilitada por el miedo intenso, la restricción física y la incapacidad percibida de escapar. Otras variables que podrían influir, tales como el tipo de eventos traumáticos, características de los mismos y características personales han sido poco o nada estudiadas. El presente estudio evaluó la capacidad de estas variables para predecir la IT en una muestra de 273 universitarios que habían experimentado al menos un suceso traumático. El 7.7% y el 13.2% de participantes reaccionaron con IT según las dos definiciones más estrictas adoptadas. La mayoría de las variables estuvieron significativamente asociadas con la IT en análisis univariantes. Sin embargo, en un análisis de regresión múltiple, sólo ciertas características de los eventos (ocurrencia de maltrato físico/ abuso sexual, número de tipos diferentes de eventos experimentados) y determinadas reacciones ante los mismos (percepción de lo traumáticos que fueron, respuesta de miedo intenso) fueron predictores significativos de la IT. Puesto que estos predictores sólo explicaron el 25% de la varianza, debería investigarse la influencia de otras variables, tales como el neuroticismo, la afectividad negativa y la sensación de falta de control personal o de recursos para afrontar los eventos traumáti-cos. Palabras clave: inmovilidad tónica; eventos traumáticos; trauma; Escala de Inmovilidad Tónica; Cuestionario de Eventos Traumáticos.Abstract: Tonic immobility (TI) is a possible reaction to danger that is facilitated by intense fear, physical restraint and perceived inability to escape. Other variables that could affect TI, such as the type and characteristics of traumatic events and personal characteristics have been little or no studied. The present study evaluated the power of these variables to predict TI in a sample of 273 college students who had experienced at least one traumatic event. Of the sample, 7.7% and 13.2% responded with TI according to the two stricter definitions adopted. Most of the variables were significantly associated with TI in univariate analyses. However, in a multiple regression analysis, only certain features of the events (occurrence of physical/sexual abuse, number of different types of events experienced) and certain reactions to them (perception of how traumatic were the events, severe fear response) were significant predictors of TI. Since these predictors explained only 25% of the variance, the influence of other variables -such as neuroticism, negative affectivity and perceived lack of personal control or resources to cope with traumatic events-should be investigated.

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A Second Look at Prior Trauma and the Posttraumatic Stress Disorder Effects of Subsequent Trauma

Cited by 255 publications

References 59 publications

Trauma and PTSD in the WHO World Mental Health Surveys

Trauma and PTSD in the WHO World Mental Health Surveys

Traumatic Event Re-exposure in Injecting Drug Users

Predictores de la inmovilidad tónica ante eventos traumáticos

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