Prevalence, risk, and correlates of posttraumatic stress disorder across ethnic and racial minority groups in the United States.
OBJECTIVE
We assess whether posttraumatic stress disorder (PTSD) varies in prevalence, diagnostic criteria endorsement, and type and frequency of potentially traumatic events (PTEs) among a nationally representative US sample of 5071 non-Latino whites, 3264 Latinos, 2178 Asians, 4249 African Americans, and 1476 Afro-Caribbeans.


METHODS
PTSD and other psychiatric disorders were evaluated using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) in a national household sample that oversampled ethnic/racial minorities (n=16,238) but was weighted to produce results representative of the general population.


RESULTS
Asians have lower prevalence rates of probable lifetime PTSD, whereas African Americans have higher rates as compared with non-Latino whites, even after adjusting for type and number of exposures to traumatic events, and for sociodemographic, clinical, and social support factors. Afro-Caribbeans and Latinos seem to demonstrate similar risk to non-Latino whites, adjusting for these same covariates. Higher rates of probable PTSD exhibited by African Americans and lower rates for Asians, as compared with non-Latino whites, do not appear related to differential symptom endorsement, differences in risk or protective factors, or differences in types and frequencies of PTEs across groups.


CONCLUSIONS
There appears to be marked differences in conditional risk of probable PTSD across ethnic/racial groups. Questions remain about what explains risk of probable PTSD. Several factors that might account for these differences are discussed, as well as the clinical implications of our findings. Uncertainty of the PTSD diagnostic assessment for Latinos and Asians requires further evaluation.
*Center for Multicultural Mental Health Research, Somerville †Cambridge Health Alliance, Cambridge ‡Harvard Medical School, Boston §Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA ∥Cooperative Studies Program Coordinating Center, VA Palo Alto Healthcare System, Palo Alto, CA ¶The Giesel School of Medicine at Dartmouth, Hanover, NH #NCPTSD VA Medical Center, White River Junction, VT **Department of Biostatistics and Computational Biology, University of Rochester Medical Center ††University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY ‡‡School of Social Work, University of Washington, Seattle, WA §§Department of Psychology, University of Michigan, Ann Arbor, MI ∥∥Department of Psychology, New York University, New York, NY.
Margarita
M
Alegría
Lisa R
LR
Fortuna
Julia Y
JY
Lin
Fran H
FH
Norris
Shan
S
Gao
David T
DT
Takeuchi
James S
JS
Jackson
Patrick E
PE
Shrout
Anne
A
Valentine
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000368:Aged; D001213:Asian / Q000523:psychology / Q000706:statistics & numerical data; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology; D008875:Middle Aged; D062072:Patient Acuity; D015995:Prevalence; D044469:Racial Groups / Q000523:psychology / Q000706:statistics & numerical data*; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult