title: Trauma exposure and posttraumatic stress disorder in a national sample of adolescents.
abstract: OBJECTIVE
  Although exposure to potentially traumatic experiences (PTEs) is common among youths in the United States, information on posttraumatic stress disorder (PTSD) risk associated with PTEs is limited. We estimate lifetime prevalence of exposure to PTEs and PTSD, PTE-specific risk of PTSD, and associations of sociodemographics and temporally prior DSM-IV disorders with PTE exposure, PTSD given exposure, and PTSD recovery among U.S. adolescents.
  
  
  METHODS
  Data were drawn from 6,483 adolescent-parent pairs in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a national survey of adolescents aged 13 through 17 years. Lifetime exposure to interpersonal violence, accidents/injuries, network/witnessing, and other PTEs was assessed along with DSM-IV PTSD and other distress, fear, behavior, and substance disorders.
  
  
  RESULTS
  A majority (61.8%) of adolescents experienced a lifetime PTE. Lifetime prevalence of DSM-IV PTSD was 4.7% and was significantly higher among females (7.3%) than among males (2.2%). Exposure to PTEs, particularly interpersonal violence, was highest among adolescents not living with both biological parents and with pre-existing behavior disorders. Conditional probability of PTSD was highest for PTEs involving interpersonal violence. Predictors of PTSD among PTE-exposed adolescents included female gender, prior PTE exposure, and pre-existing fear and distress disorders. One-third (33.0%) of adolescents with lifetime PTSD continued to meet criteria within 30 days of interview. Poverty, U.S. nativity, bipolar disorder, and PTE exposure occurring after the focal trauma predicted nonrecovery.
  
  
  CONCLUSIONS
  Interventions designed to prevent PTSD in PTE-exposed youths should be targeted at victims of interpersonal violence with pre-existing fear and distress disorders, whereas interventions designed to reduce PTSD chronicity should attempt to prevent secondary PTE exposure.
authors.affiliation: Boston Children's Hospital and Harvard Medical School, MA 02115, USA. Katie.McLaughlin@childrens.harvard.edu
authors.forename: Katie A
authors.initials: KA
authors.lastname: McLaughlin
authors.forename: Karestan C
authors.initials: KC
authors.lastname: Koenen
authors.forename: Eric D
authors.initials: ED
authors.lastname: Hill
authors.forename: Maria
authors.initials: M
authors.lastname: Petukhova
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Sampson
authors.forename: Alan M
authors.initials: AM
authors.lastname: Zaslavsky
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D002653:Child Behavior Disorders / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D010698:Phobic Disorders / Q000453:epidemiology; D055502:Secondary Prevention; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D040921:Stress Disorders, Traumatic / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data
keywords: posttraumatic stress disorder (PTSD); trauma; violence