TY  - JOUR
TI  - Trauma and PTSD in the WHO World Mental Health Surveys
AU  - Ronald C. Kessler
AU  - Sergio Aguilar‐Gaxiola
AU  - Jordi Alonso
AU  - Corina Benjet
AU  - Evelyn J. Bromet
AU  - Graça Cardoso
AU  - Louisa Degenhardt
AU  - Giovanni de Girolamo
AU  - R. Dinolova
AU  - Finola Ferry
AU  - Silvia Florescu
AU  - Oye Gureje
AU  - Josep María Haro
AU  - Yueqin Huang
AU  - Elie G. Karam
AU  - Norito Kawakami
AU  - Sing Lee
AU  - Jean-Pierre Lépine
AU  - Daphna Levinson
AU  - Fernando Navarro‐Mateu
AU  - Beth-Ellen Pennell
AU  - Marina Piazza
AU  - José Posada‐Villa
AU  - Kate M. Scott
AU  - Dan J. Stein
AU  - Margreet ten Have
AU  - Yolanda Torres
AU  - María Carmen Viana
AU  - Maria Petukhova
AU  - Nancy A. Sampson
AU  - Alan M. Zaslavsky
AU  - Karestan C. Koenen
PY  - 2017
JO  - European Journal of Psychotraumatology
DO  - 10.1080/20008198.2017.1353383
UR  - https://doi.org/10.1080/20008198.2017.1353383
AB  - Background: Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their ‘worst.’Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD.Method: WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the ‘worst’ lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview.Results: In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk.Conclusions: Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits within months after onset, mean symptom duration is considerably longer than previously recognized.
ER  -