Is traumatic stress research global? A bibliometric analysis

Abstract

BackgroundThe representation of low- and middle-income countries (LMIC) in traumatic stress research is important to establish a global evidence base, build research capacity, and reduce the burden of unmet mental health needs around the world. Reviews of the traumatic stress literature up to 2002 showed trends toward globalization although LMIC were only marginally represented compared to high-income countries (HIC).ObjectiveTo examine the global nature of current traumatic stress research. In particular, we were interested in the extent to which traumatic stress research is: (1) conducted in LMIC, (2) conducted by LMIC researchers, and (3) accessible to them.MethodUsing the databases PubMed, PsychInfo, and PILOTS, we systematically searched for peer-reviewed articles on traumatic stress published in any language in the year 2012. Out of the 3,123 unique papers identified, we coded a random sample (N=1,000) for study, author, article, and journal characteristics.ResultsAlthough our sample involved research in 56 different countries, most papers (87%) involved research in HIC, with 51% of all papers describing studies in the United States. In 88% of the papers, the author team was affiliated with HIC only. Less than 5% of all author teams involved collaborations between HIC and LMIC researchers. Moreover, 45% of the articles on LMIC studies published by a HIC corresponding author did not involve any LMIC co-authors. LMIC researchers appeared to publish empirical studies in lower impact journals. Of the 1,000 articles in our sample, 32% were open access and 10% were made available via different means; over half of the papers were not accessible without subscription.ConclusionsTraumatic stress research is increasingly global but still strongly dominated by HIC. Important opportunities to build capacity in LMIC appear to be missed. Implications toward more international traumatic stress research are discussed.

Knowledge and training in paediatric medical traumatic stress and trauma-informed care among emergency medical professionals in low- and middle-income countries

“…trauma-informed care). Consistent with observations from past research, greater knowledge was associated with higher country income (Alisic et al, 2016; Chandran et al, 2010; Fodor et al, 2014; Schnyder et al, 2016). LMIC emergency staff had somewhat greater gaps in knowledge than their high-income country counterparts and in particular were less likely to identify that toddlers can be at risk of developing paediatric medical traumatic stress and recognize behaviours that indicate risk (Alisic et al, 2016; Hoysted et al, 2017).…”

“…Further, there is cumulating evidence demonstrating that risk factors for the development of posttraumatic stress symptoms in children, adolescents and adults are consistent across cultures (Dyregrov et al, 2002; Ehntholt & Yule, 2006; Sack et al, 1997; Schnyder et al, 2016; Smith et al, 2002). Despite evidence that traumatic stress impacts children in LMICs (which are burdened with high rates of injuries and childhood trauma exposure) there is limited systematic research conducted in LMIC settings examining the efficacy of treatment approaches (Chandran et al, 2010; Foa et al, 2008; Fodor et al, 2014). Furthermore, many LMICs have limited access to resources, training and education and poor health infrastructure, which impacts implementation of evidence-based treatments and preventative measures (Chandran et al, 2010; Schnyder et al, 2016).…”

Trauma is a public health issue

“…Additional priorities for improving global mental health research include a focus on adequately training researchers around the world, ensuring a bi-directional flow of information and partnerships in the global mental health research community (Patel & Prince, 2010). Recommendations for building global trauma research capacity include: providing quality training and distance learning opportunities, supporting international fellowships, promoting memberships in collaborative research teams, improving accessibility of the scientific literature, and encouraging researchers to share their knowledge with policymakers and key stakeholders (Fodor et al, 2014). Unlike other service sectors that rely heavily on equipment or supplies, mental health services are primarily dependent on human resources (World Health Organization, 2011).…”

Children in the 2015 South Indian floods: community members’ views

“…In LMICs such as India, awareness about mental health is scarce and mental health problems are often stigmatized, while policies prioritizing mental health are largely absent (Khandelwal, Jhingan, Ramesh, Gupta, & Srivastava, 2004; Patel, 2007; Srivastava, Chatterjee, & Bhat, 2016). Consequently, there is an urgent need to make mental health a priority (Patel, 2007) and for more mental health research (Sharan et al, 2009), specifically traumatic stress research (Fodor et al, 2014; Schnyder, 2013), to be conducted in these settings. Interventions developed to suit this population would benefit from attuning to this attitude to mental health and design interventions adapted to this context.…”