Assaultive violence and the risk of posttraumatic stress disorder following a subsequent trauma.
Breslau, Peterson, and Shultz (2008) reported that prior trauma alone, in the absence of PTSD, did not predict an increased PTSD risk, relative to no prior trauma. Only prior trauma that resulted in PTSD predicted an increased PTSD risk following a subsequent trauma. Recently, Cougle, Resnick, and Kilpatrick (2009) proposed that the effect of prior trauma might vary by type of prior trauma, a possibility not considered in Breslau et al. They report that childhood sexual or physical assault, in the absence of PTSD, increased the PTSD risk following a subsequent trauma. This report examines the PTSD effects of prior assaultive violence, using data from Breslau et al. (1998). The study assessed PTSD in relation to up to three events. Analysis was performed on the subset with PTSD assessment for two distinct events, the earliest trauma and a subsequent trauma (n=967), using as reference persons with no prior trauma (n=972). Neither prior assaultive violence nor other prior traumas, in the absence of PTSD, influenced the subsequent risk of PTSD. In contrast, prior PTSD increased considerably the PTSD risk of a subsequent trauma. The limitations in Cougle et al. (2009) and in this study and future research directions are discussed.
Breslau
Naomi
N
Department of Epidemiology, Michigan State University, College of Human Medicine, B645 West Fee Hall, East Lansing, MI 48824, USA. breslau@epi.msu.edu
Peterson
Edward L
EL
D000293:Adolescent; D000328:Adult; D015984:Causality; D006801:Humans; D008016:Life Change Events; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data