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Cumulative traumas and risk thresholds: 12-month ptsd in the world mental health (WMH) surveys

dc.creatorKaram, Elie G.
dc.creatorFriedman, Matthew J.
dc.creatorHill, Eric D.
dc.creatorKessler, Ronald C.
dc.creatorMcLaughlin, Katie A.
dc.creatorPetukhova, Maria
dc.creatorSampson, Laura
dc.creatorShahly, Victoria
dc.creatorAngermeyer, Matthias C.
dc.creatorBromet, Evelyn J.
dc.creatorDe Girolamo, Giovanni
dc.creatorDe Graaf, Ron
dc.creatorDemyttenaere, Koen
dc.creatorFerry, Finola
dc.creatorFlorescu, Silvia E.
dc.creatorHaro, Josep Maria
dc.creatorHe, Yanling
dc.creatorKaram, Aimee N.
dc.creatorKawakami, Norito
dc.creatorKovess-Masfety, Viviane
dc.creatorMedina-Mora, María Elena
dc.creatorBrowne Oakley, Mark A.
dc.creatorPosada-Villa, José A.
dc.creatorShalev, Arieh Y.
dc.creatorStein, Dan J.
dc.creatorViana, Maria Carmen
dc.creatorZarkov, Zahari
dc.creatorKoenen, Karestan C.
dc.date.accessioned2017-06-29T03:44:16Z
dc.date.available2017-06-29T03:44:16Z
dc.date.issued2014es_ES
dc.identifier2619es_ES
dc.identifier.issn1091-4269es_ES
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/4468
dc.identifier.urihttps://doi.org/10.1002/da.22169es_ES
dc.description.abstractes_ES
dc.language.isoenges_ES
dc.publisheres_ES
dc.relation31(2) 130-142p.es_ES
dc.relationversión del editores_ES
dc.rightsacceso cerradoes_ES
dc.subject.meshAdolescentes_ES
dc.subject.meshAdultes_ES
dc.subject.meshAge of Onsetes_ES
dc.subject.meshChildes_ES
dc.subject.meshComorbidityes_ES
dc.subject.meshEurope/epidemiologyes_ES
dc.subject.meshFemalees_ES
dc.subject.meshHealth Surveys/methodses_ES
dc.subject.meshHealth Surveys/statistics and numerical dataes_ES
dc.subject.meshHumanses_ES
dc.subject.meshInternationalityes_ES
dc.subject.meshLife Change Eventses_ES
dc.subject.meshMalees_ES
dc.subject.meshMental Disorders/epidemiologyes_ES
dc.subject.meshMental Disorders/psychologyes_ES
dc.subject.meshPrevalencees_ES
dc.subject.meshRisk Factorses_ES
dc.subject.meshStress Disorders, Post-Traumatic/epidemiologyes_ES
dc.subject.meshStress Disorders, Post-Traumatic/psychologyes_ES
dc.subject.meshStress, Psychological/epidemiologyes_ES
dc.subject.meshStress, Psychological/psychologyes_ES
dc.subject.meshUnited States/epidemiologyes_ES
dc.subject.meshYoung Adultes_ES
dc.titleCumulative traumas and risk thresholds: 12-month ptsd in the world mental health (WMH) surveyses_ES
dc.title.alternativees_ES
dc.typeartículoes_ES
dc.contributor.affiliationDepartment of Psychiatry and Clinical Psychology, Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanones_ES
dc.contributor.emailkck5@mail.cumc.columbia.edues_ES
dc.relation.jnabreviadoDEPRESS ANXIETYes_ES
dc.relation.journalDepression and anxietyes_ES
dc.identifier.placeEstados Unidoses_ES
dc.date.published2014es_ES
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñizes_ES
dc.identifier.eissn1520-6394es_ES
dc.identifier.doi10.1002/da.22169es_ES
dc.description.monthFebes_ES
dc.description.abstractotrodiomaBackground—Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods—Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results—19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions—A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014.es_ES
dc.subject.meshmes_ES
dc.subject.kwes_ES
dc.subject.koPTSDes_ES
dc.subject.koFunctional impairmentes_ES
dc.subject.koComorbidityes_ES
dc.subject.koWorld Mental Health Surveyses_ES
dc.subject.koEpidemiologyes_ES


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