The associations of earlier trauma exposures and history of mental disorders with PTSD after subsequent traumas.
Journal: Molecular psychiatry
Volume: 23
Issue: 9
Year of Publication: 2019
Affiliated Institutions:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. Kessler@hcp.med.harvard.edu.
Center for Reducing Health Disparities, UC Davis Health System, Sacramento, CA, USA.
Health Services Research Unit, IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA.
Department of Psychiatry, University College Hospital, Ibadan, Nigeria.
Department of Psychiatry and Clinical Psychology, Faculty of Medicine, St George Hospital University Medical Center, Balamand University, Beirut, Lebanon.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong.
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Republic of South Africa.
National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico.
School of Psychology, Ulster University, Londonderry, UK.
IRCCS St John of God Clinical Research Centre//IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Ukrainian Psychiatric Association, Kiev, Ukraine.
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain.
National Center for Public Health and Analyses, Sofia, Bulgaria.
Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan.
Ecole des Hautes Etudes en Santé Publique (EHESP), EA Paris Descartes University, Paris, France.
UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain.
Colegio Mayor de Cundinamarca University, Bogota, Colombia.
Department of Psychological Medicine, University of Otago, Dunedin, New Zealand.
Department of Psychiatry, NYU Langone Medical Center, New York City, NY, USA.
Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.
Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia.
Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil.
Abstract summary
Although earlier trauma exposure is known to predict posttraumatic stress disorder (PTSD) after subsequent traumas, it is unclear whether this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pretrauma vulnerability to PTSD. We examined this issue in the World Health Organization (WHO) World Mental Health (WMH) Surveys with 34 676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (odds ratio (OR)=1.3-2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior and substance disorders before random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5-4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization and rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 years (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas.
Authors & Co-authors:
Kessler
Aguilar-Gaxiola
Alonso
Bromet
Gureje
Karam
Koenen
Lee
Liu
Pennell
Petukhova
Sampson
Shahly
Stein
Atwoli
Borges
Bunting
de Girolamo
Gluzman
Haro
Hinkov
Kawakami
Kovess-Masfety
Navarro-Mateu
Posada-Villa
Scott
Shalev
Ten Have
Torres
Viana
Zaslavsky
Study Outcome
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