Trauma exposure and posttraumatic stress disorder: a study of youths in urban America.
We estimate the cumulative occurrence of traumatic events and posttraumatic stress disorder (PTSD), using Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria, in a high-risk sample of young people in urban United States. The epidemiological sample (n = 2,311) was recruited in 1985-1986 at entry into first grade of a public school system of a large mid-Atlantic city. Participants were interviewed about history of trauma and PTSD in 2000-2002 when their mean age was 21 years (n = 1,698). We found that the lifetime occurrence of assaultive violence was 62.6% in males and 33.7% in females. The risk of assaultive violence in males (but not females) varied by childhood area of residence within the city; the occurrence of other traumas did not vary by area of childhood residence. Females had a higher risk of PTSD than males following assaultive violence (odds ratio = 4.0, 95% confidence interval 2.0-8.3), but not following other traumas. A comparison of the results from this largely inner-city sample with the results from a recent study of a largely suburban sample in another region of the United States in which the same criteria and measures of trauma and PTSD were used suggested the possibility that males' risk for assaultive violence and females' risk for PTSD following exposure to assaultive violence might vary by characteristics of the social environment.
Breslau
Naomi
N
Department of Epidemiology, Michigan State University, College of Human Medicine, B645 West Fee Hall, East Lansing 48824, USA. breslau@epi.msu.edu
Wilcox
Holly C
HC
Storr
Carla L
CL
Lucia
Victoria C
VC
Anthony
James C
JC
D000293:Adolescent; D000328:Adult; D002648:Child; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D014754:Violence / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000523:psychology*