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Risk of post-traumatic stress disorder following traumatic events in a community sample

Published online by Cambridge University Press:  17 March 2014

J. White ,
J. Pearce ,
S. Morrison ,
F. Dunstan ,
J. I. Bisson  and
D. L. Fone
J. White*
Affiliation:
Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, School of Medicine, Cardiff University, Cardiff, UK
J. Pearce
Affiliation:
Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK
S. Morrison
Affiliation:
Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK
F. Dunstan
Affiliation:
Institute of Primary Care and Public Health, School of Medicine, Cardiff University, UK
J. I. Bisson
Affiliation:
Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, UK
D. L. Fone
Affiliation:
Institute of Primary Care and Public Health, School of Medicine, Cardiff University, UK
*
*Address for correspondence: Dr J. White, Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, School of Medicine, 4th floor Neuadd Meirionnydd, Cardiff University, Heath Park, Cardiff CF14 4YS, UK. (Email: WhiteJ11@cardiff.ac.uk)
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Abstract

Aims.

Post-traumatic stress disorder (PTSD) is typically associated with high-risk population groups, but the risk of PTSD that is associated with trauma experienced in the community, and effect of changes in diagnostic criteria in DSM-5 on prevalence in the general population, is unknown.

Methods.

Cross-sectional analysis of population-based data from 4558 adults aged 25–83 years resident in Caerphilly county borough, Wales, UK. Exposure to different traumatic events was assessed using categorisation of free-text descriptions of trauma. PTSD caseness was determined using items assessing Diagnostic and Statistical Manual IV (DSM-IV) and DSM-5 A criteria and the Traumatic Screening Questionnaire.

Results.

Of the 4558 participants, 1971 (47.0%) reported a traumatic event. The most common DSM-IV A1 qualifying trauma was life-threatening illnesses and injuries (13.6%). The highest risk of PTSD was associated with assaultive violence [34.1%]. The prevalence of PTSD using DSM-IV A criteria was 14.3% (95% confidence interval [CI] = 12.8, 15.9%). Using DSM-5 A criteria reduced the prevalence to 8.0 (95% CI = 6.9, 9.4%), primarily due to exclusion of DSM-IV A1 qualifying events, such as life-threatening illnesses.

Conclusions.

Nearly one-half of a general community sample had experienced a traumatic event and of these around one in seven was a DSM-IV case of PTSD. Although the majority of research has concentrated on combat, rape and assaultive violence, life threatening illness is a more common cause of PTSD in the community. Removal of this traumatic event in DSM-5 could reduce the number of cases of PTSD by around 6.0%.

Keywords

Epidemiologypost-traumatic stress disordertraumatraumatic event
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 24 , Issue 3 , June 2015 , pp. 249 - 257
Copyright
Copyright © Cambridge University Press 2014 

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