Probable Posttraumatic Stress Disorder and Psychiatric Co-morbidity among Latino Primary Care Patients in Puerto Rico

Vera, Mildred; Juarbe, Deborah; Hernández, Norberto; Obén, Adriana; Pérez-Pedrogo, Coralee; Chaplin, William F.

doi:10.4172/2167-1044.1000124

Cited by 9 publications

(10 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We used a cutpoint of ≥3 (yes to 3 or more questions) as indicative of traumatic stress risk. A cut off of 3 points is consistent with prior studies, including among Latinx respondents in a primary care setting, and demonstrates optimal sensitivity for probable PTSD (sensitivity of .78 and specificity of .87; Cameron & Gusman, 2003; Vera, 2012). Cronbach’s alpha for our sample was .73.…”

Section: Methodssupporting

confidence: 75%

The role of resilience and gender: Understanding the relationship between risk for traumatic stress, resilience, and academic outcomes among minoritized youth.

Ijadi-Maghsoodi¹,

Venegas-Murillo²,

Klomhaus³

et al. 2022

Psychological Trauma: Theory, Research, Practice, and Policy

View full text Add to dashboard Cite

Objective: Minoritized students experience high trauma rates which can impact academic outcomes, and experiences may differ between males and females. We investigated the relationship between traumatic stress and academic outcomes by gender among predominantly minoritized students, and whether resilience-building assets can mediate the relationship between traumatic stress and academic outcomes. Method: School administrative data were linked to survey data from 9th graders in 2016-2018 across 37 West Coast schools. We examined the association between traumatic stress risk and academic outcomes by gender. Where significant associations were found, mixed effects regression models accounting for school-level variation were fit to assess the role of resilience-building assets as potential mediators of the relationship between traumatic stress risk and academic outcomes. Results: Among 1,750 female and 2,036 male students, we found no significant association between traumatic stress risk and low attendance (,96% days attended). The odds of low grade point average (GPA ,2.0) were significantly higher among female students with traumatic stress risk (OR = 1.46, 95% CI [1.16, 1.84]), with no association among males. In models controlling for resilience-building assets, the magnitude of the association between traumatic stress risk and GPA ,2.0 among females was reduced. We identified significant mediation for 3 resilience measures: self-efficacy (21.20%; p , .05), school support (18.97%; p , .05), and total internal assets (27.84%; p , .01). Conclusions: Resilience-building assets may partially mediate the effect of traumatic stress on GPA among females. Resilience initiatives, especially among minoritized female students, may protect against the effect of trauma on academics. Clinical Impact StatementFrom a sample of minoritized 9th grade students from a large school district, we found that the odds of having a low GPA were significantly higher among female students with traumatic stress risk; however, we found no association among males. We found that the association between traumatic stress and GPA among female students may be partially explained by several resilience characteristics. It may be helpful for schools-and clinicians working within schools-to focus on bolstering This article was published Online First

show abstract

Section: Methodssupporting

confidence: 75%

The role of resilience and gender: Understanding the relationship between risk for traumatic stress, resilience, and academic outcomes among minoritized youth.

Ijadi-Maghsoodi¹,

Venegas-Murillo²,

Klomhaus³

et al. 2022

Psychological Trauma: Theory, Research, Practice, and Policy

View full text Add to dashboard Cite

show abstract

“…The point prevalence of substantial PTSD/clinically important PTSD symptoms based on questionnaire thresholds ranged from 2.9% to 39.1% (15 studies 17, 19, 21, 22, 26, 27, 33, 38, 40, 42, 46, 5329, 34, 36 ). The median point prevalence of PTSD in all primary care samples was 12.5% (civilian population median [N = 21]: 11.1%, special risk population median [N = 3]: 12.5%, and veteran median [N = 7]: 24.5%).…”

Section: Resultsmentioning

confidence: 99%

The Prevalence of Posttraumatic Stress Disorder in Primary Care: A Systematic Review

Spottswood

Davydow

Huang

2017

Harv Rev Psychiatry

View full text Add to dashboard Cite

Background There is limited information on the prevalence of posttraumatic stress disorder (PTSD) across primary care settings. Objective Determine the prevalence of clinician-diagnosed PTSD and questionnaire-ascertained PTSD symptoms in primary care patients. Methods A systematic review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, searching MEDLINE, CINAHL, Cochrane Database, PsychINFO, EMBASE, Google Scholar, and relevant book chapter bibliographies. Studies that reported on the prevalence, including point and/or lifetime prevalence, of PTSD ascertained using diagnostic interviews, self-report questionnaires, or from administrative data, among patients seen in primary care were deemed eligible for inclusion. We abstracted data on the PTSD assessment tool, the mean questionnaire scores/cutoff scores, the time period of PTSD symptoms, and PTSD prevalence reported. Results Of 10,613 titles screened, 41 studies were eligible for inclusion. The included studies assessed PTSD in a total of 7,256,826 primary care patients. The median point prevalence of PTSD across studies was 12.5%. The point prevalence of the civilian population median was 11.1%, the special risk population median was 12.5%, and the veteran median was 24.5%. The point prevalence of diagnostic interview-ascertained PTSD ranged from 2% to 32.5%, the point prevalence of questionnaire-based substantial PTSD symptoms ranged from 2.9% to 39.1%. Lifetime prevalence of diagnostic interview ascertained-PTSD ranged from 14.5% to 44.3%. The prevalence of PTSD in administrative data-based studies ranged from 3.5% to 48.8%. Conclusions PTSD is common in primary care settings. Additional research on effective and generalizable interventions for PTSD in primary care is needed.

show abstract

“…[34][35][36] The PC-PTSD screen, developed by the National Center for PTSD in Washington, DC, is the most widely used PTSD screening tool that was designed to be used in primary care settings where time and resources are limited. 31 The PC-PTSD screen assesses current PTSD symptoms (past month) and is consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic criteria, including intrusive experiencing, avoidance behaviors, hypervigilance, and emotional numbing.…”

Section: Primary Care Posttraumatic Stress Disorder Screenmentioning

confidence: 99%

Patient Preferences for Discussing Childhood Trauma in Primary Care

Goldstein

Athale

Sciolla

et al. 2017

TPJ

View full text Add to dashboard Cite

Context: Exposure to traumatic events is common in primary care patients, yet health care professionals may be hesitant to assess and address the impact of childhood trauma in their patients.Objective: To assess patient preferences for discussing traumatic experiences and posttraumatic stress disorder (PTSD) with clinicians in underserved, predominantly Latino primary care patients.Design: Cross-sectional study. Main Outcome Measure:We evaluated patients with a questionnaire assessing comfort to discuss trauma exposure and symptoms using the Adverse Childhood Experiences (ACE) Study questionnaire and the Primary Care-PTSD screen. The questionnaire also assessed patients' confidence in their clinicians' ability to help with trauma-related issues. Surveys were collected at an integrated medical and behavioral health care clinic.Results: Of 178 adult patients asked, 152 (83%) agreed to participate. Among participants, 37% screened positive for PTSD, 42% reported 4 or more ACEs, and 26% had elevated scores on both measures. Primary Care-PTSD and ACE scores were strongly positively correlated (r = 0.57, p < 0.001). Most patients agreed they were comfortable being asked about trauma directly or through screening questionnaires and did not oppose the inclusion of trauma-related information in their medical record. In addition, most patients perceived their clinician as comfortable asking questions about childhood trauma and able to address trauma-related problems.Conclusion: Screening is acceptable to most primary care patients regardless of trauma exposure or positive PTSD screening. Findings may aid primary care clinicians to consider screening regularly for ACEs and PTSD to better serve the health care needs of trauma-exposed patients.

show abstract

Probable Posttraumatic Stress Disorder and Psychiatric Co-morbidity among Latino Primary Care Patients in Puerto Rico

Cited by 9 publications

References 55 publications

The role of resilience and gender: Understanding the relationship between risk for traumatic stress, resilience, and academic outcomes among minoritized youth.

The role of resilience and gender: Understanding the relationship between risk for traumatic stress, resilience, and academic outcomes among minoritized youth.

The Prevalence of Posttraumatic Stress Disorder in Primary Care: A Systematic Review

Patient Preferences for Discussing Childhood Trauma in Primary Care

Contact Info

Product

Resources

About