title: Long-term effects of lifetime trauma exposure in a rural community sample.
abstract: BACKGROUND
  This study examines the long-term outcomes of lifetime trauma exposure, including factors that contribute to the development of PTSD, in a sample of rural adults.
  
  
  METHODS
  In 623 rural community residents, lifetime trauma exposure, PTSD, other psychiatric disorders and lifetime suicidal ideation were assessed using the World Mental Health Composite International Diagnostic Interview. Logistic regressions were used to examine relationships between potentially traumatic events (PTEs) and lifetime PTSD and other diagnoses.
  
  
  RESULTS
  78.2% of participants reported at least on PTE. Rates were broadly comparable with Australian national data: the most commonly endorsed events were unexpected death of a loved one (43.7%); witnessing injury or death (26.3%); and life-threatening accident (19.3%). While the mean age of the sample was 55 years, the mean age of first trauma exposure was 19 years. The estimated lifetime rate of PTSD was 16.0%. Events with the strongest association with PTSD were physical assault and unexpected death of a loved one. Current functioning was lowest among those with current PTSD, with this group reporting elevated psychological distress, higher mental health service use, a greater number of comorbidities, and lower perceived social support. Respondents with a past PTE but no PTSD history were generally similar in terms of their current wellbeing to those with no lifetime PTE.
  
  
  CONCLUSIONS
  PTEs may have diverse psychological and social consequences beyond the development of PTSD. Ensuring that adequate support services are available in rural areas, particularly in the period immediately following a PTE, may reduce the long-term impact of traumatic events.
authors.affiliation: Centre for Rural and Remote Mental Health, University of Newcastle, Level 5 McAuley Building, Callaghan, 2308, NSW, Australia. tonelle.handley@newcastle.edu.au.|National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia. tonelle.handley@newcastle.edu.au.
authors.forename: Tonelle E
authors.initials: TE
authors.lastname: Handley
authors.affiliation: Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, NSW, Australia. brian.kelly@newcastle.edu.au.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Kelly
authors.affiliation: Hunter New England Mental Health Services, Newcastle, NSW, Australia. terry.lewin@hnehealth.nsw.gov.au.
authors.forename: Terry J
authors.initials: TJ
authors.lastname: Lewin
authors.affiliation: Sydney Centre for ATSI Statistics, University of Sydney, Sydney, NSW, Australia. clare.coleman@sydney.edu.au.
authors.forename: Clare
authors.initials: C
authors.lastname: Coleman
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, Durham, UK. helen.stain@durham.ac.uk.
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Stain
authors.affiliation: Research Services, University of Newcastle, Newcastle, NSW, Australia. natasha.weaver@newcastle.edu.au.
authors.forename: Natasha
authors.initials: N
authors.lastname: Weaver
authors.affiliation: Centre for Rural and Remote Mental Health, University of Newcastle, Level 5 McAuley Building, Callaghan, 2308, NSW, Australia. kerry.inder@newcastle.edu.au.|School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia. kerry.inder@newcastle.edu.au.
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Inder
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008603:Mental Health; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D012424:Rural Population; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D059020:Suicidal Ideation; D013997:Time Factors