The prevalence of posttraumatic stress disorder among American Indian Vietnam veterans: Disparities and context

Beals, Janette; Manson, Spero M.; Shore, James H.; Friedman, Matthew J.; Ashcraft, Marie; Fairbank, John A.; Schlenger, William E.

doi:10.1023/a:1014894506325

Cited by 128 publications

(93 citation statements)

References 20 publications

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“…Only alcohol and/or drug dependence appeared to have a positive correlation associated with CD, but this variable was not associated with level of war zone stress or war-related PTSD symptoms. One possible explanation for these results could be a ceiling effect, given the elevated rates of CD and war zone stress in AI veterans compared to White veterans (Beals et al, 2002). Blacks and Hispanics have also been found to have higher absolute rates of PTSD but are likewise exposed to higher levels of war zone stress (Frueh et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

“…Women were excluded due to the small numbers of AI female veterans who served. First, tribal rolls identified all recognized male members of the given tribal groups (Beals et al, 2002). Men born between 1930 and 1958 were selected from the rolls.…”

Section: Samplementioning

confidence: 99%

“…A recent study found that AI Vietnam veterans have higher rates of PTSD and PTSD symptoms than White veterans (Beals et al, 2002). Increased exposure to objective and subjective war zone stress largely accounted for this difference.…”

mentioning

confidence: 97%

“…Congress directed the National Center for PTSD within the Department of Veterans Affairs to extend the National Vietnam Veteran Readjustment Study (NVVRS) to minority groups beyond Blacks and Hispanics (Kulka et al, 1990). The National Center for American Indian and Alaska Native Mental Health Research conducted the AI portion of this effort (Beals et al, 2002;Gurley et al, 2001). …”

mentioning

confidence: 99%

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Conduct disorder, war zone stress, and war‐related posttraumatic stress disorder symptoms in American Indian Vietnam veterans

Dillard

Jacobsen

Ramsey

et al. 2007

Journal of Traumatic Stress

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This study examined whether conduct disorder (CD) was associated with war zone stress and warrelated post-traumatic stress disorder (PTSD) symptoms in American Indian (AI) Vietnam veterans. Cross-sectional lay-interview data was analyzed for 591 male participants from the American Indian Vietnam Veterans Project. Logistic regression evaluated the association of CD with odds of high war zone stress and linear regression evaluated the association of CD and PTSD symptom severity. Childhood CD was not associated with increased odds of high war zone stress. CD was associated with elevated war-related PTSD symptoms among male AI Vietnam Veterans independent of war zone stress level and other mediators. Future efforts should examine reasons for this association and whether the association exists in other AI populations.Posttraumatic stress disorder (PTSD) is a common and serious problem among U.S. military combat veterans (Koenen et al., 2002). Studies consistently find that the severity of war-related PTSD symptoms is positively associated with the degree of exposure to war zone stress. Combat is the form of stress most commonly studied (Green, Grace, Lindy, Gleser, & Leonard, 1990;King, King, Foy, Keane, & Fairbank, 1999). However, war zone stress can be defined as a combination of both objective and subjective factors. Objective factors include direct combat experience and exposure to atrocities, while subjective factors include perceived threat and deprivation in the war zone. Each of these types of stress differentially affect PTSD symptoms (King, King, Gudanowski, & Vreven, 1995). Factors occurring before and after the war also affect war zone stress and PTSD symptoms. These factors can include demographic variables such as age and education, service factors such as rank, and the presence of other mental illness, including substance dependence (Brewin, Andrews, & Valentine, 2000;Davidson, Hughes, Blazer, & George, 1991;Frueh, Brady, & de Arellano, 1998;Green et al., 1990;King, King, Foy, & Gudanowski, 1996;Wolfe, Erickson, Sharkansky, King, & King, 1999). For instance, males who are younger when they enter the military experience higher levels of combat than those who are older at entry (King et al., 1996).Childhood antisocial behavior is another important factor associated with exposure to war zone combat and PTSD symptoms in national samples of Vietnam veterans Koenen et al., 2002). People with antisocial characteristics may perceive less threat in a war (King et al., 1996), and risk-taking behavior associated with childhood conduct disorder (CD) may increase chances of trauma exposure (Koenen et al, 2002). Individuals with CD may have insufficient resources to cope with the sequelae of stressful or traumatic events once exposed (Koenen et al., 2002). Since onset of CD precedes the minimum age for military enrollment, the veteran population is well suited to study the potential association between CD and PTSD symptoms. Methods SampleWe conducted a retrospective analysis using cross-sectional data from...

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Section: Discussionmentioning

confidence: 99%

Section: Samplementioning

confidence: 99%

mentioning

confidence: 97%

mentioning

confidence: 99%

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Conduct disorder, war zone stress, and war‐related posttraumatic stress disorder symptoms in American Indian Vietnam veterans

Dillard

Jacobsen

Ramsey

et al. 2007

Journal of Traumatic Stress

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“…Detailed information regarding the design and methods utilized in AI-SUPERPFP are described elsewhere (Beals et al, 2003;Beals et al, 2004;Beals et al, 2005). The diagnostic interview utilized in AI-SUPERPFP was a version of the NCS University of Michigan version of the Composite International Diagnostic Interview (UM-CIDI) adapted for use in American Indian communities in the context of a previous study (Beals et al, 2002). Characteristics of the AI-SUPERPFP sample are summarized in the left-hand column of Table 1. In AI-SUPERPFP, service utilization was assessed by three different sets of questions.…”

Section: American Indian Service Utilization and Psychiatric Epidemiomentioning

confidence: 99%

Methods for measuring utilization of mental health services in two epidemiologic studies

Novins

Beals

Croy

et al. 2008

Int J Methods Psych Res

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Objectives of Study-Psychiatric epidemiologic studies often include two or more sets of questions regarding service utilization, but the agreement across these different questions and the factors associated with their endorsement have not been examined. The objectives of this study were to describe the agreement of different sets of mental health service utilization questions that were included in the American Indian Service Utilization Psychiatric Epidemiology Risk and Protective Factors Project (AI-SUPERPFP), and compare the results to similar questions included in the baseline National Comorbidity Survey (NCS).Methods-Responses to service utilization questions by 2878 AI-SUPERPFP and 5877 NCS participants were examined by calculating estimates of service use and agreement (κ) across the different sets of questions. Logistic regression models were developed to identify factors associated with endorsement of specific sets of questions.Results-In both studies, estimates of mental health service utilization varied across the different sets of questions. Agreement across the different question sets was marginal to good (κ = 0.27-0.69). Characteristics of identified service users varied across the question sets.Limitations-Neither survey included data to examine the validity of participant responses to service utilization questions.Recommendations for Further Research-Question wording and placement appear to impact estimates of service utilization in psychiatric epidemiologic studies. Given the importance of these estimates for policy-making, further research into the validity of survey responses as well as impacts of question wording and context on rates of service utilization is warranted.

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Challenges in Operationalizing the DSM-IV ClinicalSignificance Criterion

Beals

Novins

Spicer

et al. 2004

Arch Gen Psychiatry

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The prevalence of posttraumatic stress disorder among American Indian Vietnam veterans: Disparities and context

Cited by 128 publications

References 20 publications

Conduct disorder, war zone stress, and war‐related posttraumatic stress disorder symptoms in American Indian Vietnam veterans

Conduct disorder, war zone stress, and war‐related posttraumatic stress disorder symptoms in American Indian Vietnam veterans

Methods for measuring utilization of mental health services in two epidemiologic studies

Challenges in Operationalizing the DSM-IV ClinicalSignificance Criterion

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