title: Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys.
abstract: Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20-40% range in disaster-focused studies but considerably lower (3-5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies.
  
  
  
  Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders).
  
  
  
  Disaster-related PTSD prevalence was 0.0-3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk.
  
  
  
  Disaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions.
authors: Department of Psychiatry,Stony Brook University School of Medicine,Stony Brook, NY,USA.
authors: E J
authors: EJ
authors: Bromet
authors: Department of Mental Health,Moi University School of Medicine,Eldoret,Kenya.
authors: L
authors: L
authors: Atwoli
authors: Department of Mental Health,School of Public Health,The University of Tokyo,Tokyo,Japan.
authors: N
authors: N
authors: Kawakami
authors: Subdirección General de Salud Mental, Servicio Murciano de Salud, IMIB-Arrixaca, CIBER de Epidemiología y Salud Pública (CIBERESP),Murcia,Spain.
authors: F
authors: F
authors: Navarro-Mateu
authors: Department of Psychiatry,Wroclaw Medical University,Wroclaw,Poland.
authors: P
authors: P
authors: Piotrowski
authors: Department of Health Care Policy,Harvard Medical School,Boston, MA,USA.
authors: A J
authors: AJ
authors: King
authors: University of California Davis School of Medicine,Sacramento, CA,USA.
authors: S
authors: S
authors: Aguilar-Gaxiola
authors: IMIM-Hospital del Mar Research Institute,Parc de Salut Mar,Barcelona,Spain.
authors: J
authors: J
authors: Alonso
authors: School of Psychology, University of Ulster,Londonderry,UK.
authors: B
authors: B
authors: Bunting
authors: Department of Psychiatry,University Hospital Gasthuisberg, Katholieke Universiteit Leuven,Leuven,Belgium.
authors: K
authors: K
authors: Demyttenaere
authors: National School of Public Health, Management and Professional Development,Bucharest,Romania.
authors: S
authors: S
authors: Florescu
authors: IRCCS St. John of God Clinical Research Centre,Brescia,Italy.
authors: G
authors: G
authors: de Girolamo
authors: Ukrainian Psychiatric Association,Kiev,Ukraine.
authors: S
authors: S
authors: Gluzman
authors: Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona,Barcelona,Spain.
authors: J M
authors: JM
authors: Haro
authors: Department of Psychiatry,Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen,Groningen,The Netherlands.
authors: P
authors: P
authors: de Jonge
authors: Department of Psychiatry and Clinical Psychology, Faculty of Medicine,Balamand University,Beirut,Lebanon.
authors: E G
authors: EG
authors: Karam
authors: Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong.
authors: S
authors: S
authors: Lee
authors: Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University,Paris,France.
authors: V
authors: V
authors: Kovess-Masfety
authors: Ramon de la Fuente Muñiz National Institute of Psychiatry,Mexico City,Mexico.
authors: M E
authors: ME
authors: Medina-Mora
authors: Survey Research Center, Institute for Social Research, University of Michigan,Ann Arbor, MI,USA.
authors: Z
authors: Z
authors: Mneimneh
authors: Survey Research Center, Institute for Social Research, University of Michigan,Ann Arbor, MI,USA.
authors: B-E
authors: BE
authors: Pennell
authors: Colegio Mayor de Cundinamarca University,Bogota,Colombia.
authors: J
authors: J
authors: Posada-Villa
authors: Department of Epidemiology,Department of Health and Social Sciences,Murcia Regional Health Council, IMIB-Arrixaca, CIBER Epidemiología y Salud Pública (CIBERESP), Universidad de Murcia,Murcia,Spain.
authors: D
authors: D
authors: Salmerón
authors: Department of Health and Welfare for the Disabled,Health and Welfare Bureau,Kawasaki City,Japan.
authors: T
authors: T
authors: Takeshima
authors: Department of Health Care Policy,Harvard Medical School,Boston, MA,USA.
authors: R C
authors: RC
authors: Kessler
mesh_terms: D019049:Developed Countries / Q000706:statistics & numerical data*; D003906:Developing Countries / Q000706:statistics & numerical data*; D004190:Disasters / Q000706:statistics & numerical data*; D014943:Global Health; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D008603:Mental Health / Q000706:statistics & numerical data; D015233:Models, Statistical; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology*
keywords: Disaster; PTSD; post-traumatic stress disorder