title: Risk of post-traumatic stress disorder following traumatic events in a community sample.
abstract: OBJECTIVE
  Post-traumatic stress disorder (PTSD) is typically associated with high-risk population groups, but the risk of PTSD that is associated with trauma experienced in the community, and effect of changes in diagnostic criteria in DSM-5 on prevalence in the general population, is unknown.
  
  
  METHODS
  Cross-sectional analysis of population-based data from 4558 adults aged 25-83 years resident in Caerphilly county borough, Wales, UK. Exposure to different traumatic events was assessed using categorisation of free-text descriptions of trauma. PTSD caseness was determined using items assessing Diagnostic and Statistical Manual IV (DSM-IV) and DSM-5 A criteria and the Traumatic Screening Questionnaire.
  
  
  RESULTS
  Of the 4558 participants, 1971 (47.0%) reported a traumatic event. The most common DSM-IV A1 qualifying trauma was life-threatening illnesses and injuries (13.6%). The highest risk of PTSD was associated with assaultive violence [34.1%]. The prevalence of PTSD using DSM-IV A criteria was 14.3% (95% confidence interval [CI] = 12.8, 15.9%). Using DSM-5 A criteria reduced the prevalence to 8.0 (95% CI = 6.9, 9.4%), primarily due to exclusion of DSM-IV A1 qualifying events, such as life-threatening illnesses.
  
  
  CONCLUSIONS
  Nearly one-half of a general community sample had experienced a traumatic event and of these around one in seven was a DSM-IV case of PTSD. Although the majority of research has concentrated on combat, rape and assaultive violence, life threatening illness is a more common cause of PTSD in the community. Removal of this traumatic event in DSM-5 could reduce the number of cases of PTSD by around 6.0%.
authors.affiliation: Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, School of Medicine,Cardiff University,Cardiff,UK.
authors.forename: J
authors.initials: J
authors.lastname: White
authors.affiliation: Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, University Hospital of Wales,Cardiff,UK.
authors.forename: J
authors.initials: J
authors.lastname: Pearce
authors.affiliation: Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, University Hospital of Wales,Cardiff,UK.
authors.forename: S
authors.initials: S
authors.lastname: Morrison
authors.affiliation: Institute of Primary Care and Public Health, School of Medicine, Cardiff University,UK.
authors.forename: F
authors.initials: F
authors.lastname: Dunstan
authors.affiliation: Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, University Hospital of Wales,Cardiff,UK.
authors.forename: J I
authors.initials: JI
authors.lastname: Bisson
authors.affiliation: Institute of Primary Care and Public Health, School of Medicine, Cardiff University,UK.
authors.forename: D L
authors.initials: DL
authors.lastname: Fone
keywords: Epidemiology; post-traumatic stress disorder; trauma; traumatic event