Experiences of Traumatic Events and Associations with PTSD and Depression Development in Urban Health Care-seeking Women

Abstract

Posttraumatic stress disorder (PTSD) is an anxiety disorder that occurs after a traumatic event and has been linked to psychiatric and physical health declines. Rates of PTSD are far higher in individuals with low incomes and who reside in urban areas compared to the general population. In this study, 250 urban health care-seeking women were interviewed for a diagnosis of PTSD, major depressive disorder, and also the experience of traumatic events. Multivariate logistic regressions were used to determine the associations between traumatic events and PTSD development. Survival analysis was used to determine if PTSD developed from assaultive and nonassaultive events differed in symptom duration. Eighty-six percent of women reported at least one traumatic event, 14.8% of women were diagnosed with current PTSD, and 19.6% with past PTSD. More than half of women with PTSD had comorbid depression. Assaultive traumatic events were most predictive of PTSD development. More than two thirds of the women who developed PTSD developed chronic PTSD. Women who developed PTSD from assaultive events experienced PTSD for at least twice the duration of women who developed PTSD from nonassaultive events. In conclusion, PTSD was very prevalent in urban health care-seeking women. Assaultive violence was most predictive of PTSD development and also nonremittance.

Pathways of Chronic Pain in Survivors of Intimate Partner Violence

“…This may be related to clinicians not inquiring about past trauma once they have diagnosed depression or women's lack of comfort in reporting abuse experiences. Gill et al 67 observed that if traumatized women who seek help for chronic physical health problems are not assessed and treated for their underlying response to trauma, their physical symptoms are likely to continue. Health problems have been found to be a major interference for women struggling to provide for their families and create new lives after leaving abusive partners.…”

Associations between posttraumatic stress disorder and hemoglobin A1C in low-income minority patients with diabetes

“…Studies assessing the role of mental health on these disparities have focused largely on major depression. However, there is growing evidence that posttraumatic stress disorder (PTSD) is also associated with chronic disease and with poorer health outcomes [2,3]. …”

“…Compared to a national lifetime prevalence of 7.8% [5], PTSD occurs at rates of 10 to over 50% in urban primary care settings [2,6,7]. This observation is partly explained by the high prevalence of trauma in poor urban environments, which consistently ranges from 65% to over 80% in both community and primary care settings [2,3,6,8]. Minorities are more likely to be victims of direct assault (e.g., physical and sexual assault) [9,10] and to experience indirect violence (e.g., witnessing assault) compared to Caucasians [11].…”

Military Sexual Trauma Exposure and Heart Rate Variability Outcomes in Female Veterans

“…Additionally, women exposed to stress from traumatic events are 2.8 times more likely to develop posttraumatic stress disorder (PTSD) than men (Holbrook, Hoyt, Stein, & Sieber, 2002). Women who develop PTSD often experienced numerous traumatic events in life (mean (Gill, Page, Sharps, & Campbell, 2008;Holbrook et al, 2002) and are at risk of repeatedly re-experiencing traumatic events through flashbacks, intrusive thoughts, and dreams (Gill, Saligan, Henderson, & Szanton, 2009; United States Department of Veterans Affairs [US Department of Veteran Affairs], 2010a) with potential for additional impact on autonomic tone (Cohen, Benjamin, et al, 2000). Stress had a greater effect on the sinus and atrioventricular nodes in women (Insulander & Vallin, 2005), and women exhibited greater cardiac response with repeated stress than men (Schmaus et al, 2008).…”