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Influence of predispositions on post-traumatic stress disorder: does it vary by trauma severity?

Published online by Cambridge University Press:  18 June 2012

N. Breslau ,
J. P. Troost ,
K. Bohnert  and
Z. Luo
N. Breslau*
Affiliation:
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
J. P. Troost
Affiliation:
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
K. Bohnert
Affiliation:
Serious Mental Illness Treatment Resource and Evaluation Center, Department of Veterans Affairs, Ann Arbor, MI, USA
Z. Luo
Affiliation:
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
*
*Address for correspondence: N. Breslau, Ph.D., Department of Epidemiology and Biostatistics, Michigan State University, College of Human Medicine, B645 West Fee Hall, East Lansing, MI 48824, USA. (Email: breslau@epi.msu.edu)
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Abstract

Background

Only a minority of trauma victims (<10%) develops post-traumatic stress disorder (PTSD), suggesting that victims vary in predispositions to the PTSD response to traumas. It is assumed that the influence of predispositions is inversely related to trauma severity: when trauma is extreme predispositions are assumed to play a secondary role. This assumption has not been tested. We estimate the influence of key predispositions on PTSD induced by an extreme trauma – associated with a high percentage of PTSD – (sexual assault), relative to events of lower magnitude (accidents, disaster, and unexpected death of someone close).

Method

The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) is representative of the adult population of the USA. A total of 34 653 respondents completed the second wave in which lifetime PTSD was assessed. We conducted three series of multinomial logistic regressions, comparing the influence of six predispositions on the PTSD effect of sexual assault with each comparison event. Three pre-existing disorders and three parental history variables were examined.

Results

Predispositions predicted elevated PTSD risk among victims of sexual assault as they did among victims of comparison events. We detected no evidence that the influence of predispositions on PTSD risk was significantly lower when the event was sexual assault, relative to accidents, disasters and unexpected death of someone close.

Conclusions

Important predispositions increase the risk of PTSD following sexual assault as much as they do following accidents, disaster, and unexpected death of someone close. Research on other predispositions and alternative classifications of event severity would be illuminating.

Keywords

Epidemiologypost-traumatic stress disorderpredispositionssexual assaulttrauma
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 2 , February 2013 , pp. 381 - 390
Copyright
Copyright © Cambridge University Press 2012

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