Abstract

Although earlier trauma exposure is known to predict posttraumatic stress disorder (PTSD) after subsequent traumas, it is unclear whether this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pretrauma vulnerability to PTSD. We examined this issue in the World Health Organization (WHO) World Mental Health (WMH) Surveys with 34 676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (odds ratio (OR)=1.3–2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior and substance disorders before random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5–4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization and rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 years (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas.

Original languageEnglish
Pages (from-to)1892-1899
Number of pages8
JournalMolecular Psychiatry
Volume23
Issue number9
DOIs
StatePublished - 1 Sep 2018
Externally publishedYes

Funding

FundersFunder number
Alcohol Advisory Council
CONACyT-G30544-H
Eli Lilly Romania SRL
INPRFMDIES4280
Israel National Health Survey
Israel National Institute for Health Policy and Health Services Research
Lebanese Evaluation of the Burden of Ailments and Needs Of the Nation
Mexican National Comorbidity Survey
Ministry of Social Protection
National Center for Public Health Protection
National Institute for Research & Development in Health
National Institute of Statistics-National Centre for Training in Statistics
New Zealand Mental Health Survey
PanAmerican Health Organization
Servicio Murciano de Salud and Consejería de Sanidad y Política Social
South African Department of Health
São Paulo Megacity Mental Health Survey
National Institutes of Health
National Institute of Mental HealthR01MH061905, U01-MH60220, R01-MH059575
National Institute on Drug Abuse
Substance Abuse and Mental Health Services Administration
Fogarty International CenterR03 TW006481-01
Robert Wood Johnson Foundation044708
John W. Alden Trust
Pfizer
GlaxoSmithKline
World Health Organization
University of Michigan
Ministry of Health
European CommissionQLG5-1999-01042, SANCO 2004123, EAHC 20081308
South African Medical Research CouncilT32 MH017119
Ministry of Health, New Zealand
Health Research Council of New Zealand
Public Health Agency
Fundação de Amparo à Pesquisa do Estado de São Paulo03/00204-3
Consejo Nacional de Ciencia y Tecnología
National Insurance Institute of IsraelH16-KOKORO-013, H14-TOKUBETSU-026, H13-SHOGAI-023
Ministry of Health, Labour and Welfare
Ministry of Public Health
Instituto de Salud Carlos IIIFIS 00/0028
Università degli Studi del Piemonte Orientale
Ministerio de Ciencia y TecnologíaSAF 2000-158-CE
Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
Fundación para la Formación e Investigación Sanitarias de la Región de MurciaRO1-MH61905
Regione Piemonte
Departament de Salut, Generalitat de CatalunyaRETICS RD06/0011 REM-TAP, CB06/02/0046
Ministerio de Salud

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