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Lifetime Prevalence of Posttraumatic Stress Disorder in Two American Indian Reservation Populations

Authors

  • Janette Beals,

    Corresponding author
    • Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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  • Spero M. Manson,

    1. Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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  • Calvin Croy,

    1. Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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  • Suzell A. Klein,

    1. Latino Research and Policy Center, Colorado School of Public Health, University of Colorado Denver, Denver, Colorado, USA
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  • Nancy Rumbaugh Whitesell,

    1. Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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  • Christina M. Mitchell,

    1. Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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  • The AI-SUPERPFP Team

    1. Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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  • In addition to the authors listed above, the AI-SUPERPFP team includes Cecelia K. Big Crow, Dedra Buchwald, Buck Chambers, Michelle L. Christensen, Denise A. Dillard, Karen DuBray, Paula A. Espinoza, Candace M. Fleming, Ann Wilson Frederick, Joseph Gone, Diana Gurley, Lori L. Jervis, Shirlene M. Jim, Carol E. Kaufman, Ellen M. Keane, Denise Lee, Monica C. McNulty, Denise L. Middlebrook, Laurie A. Moore, Tilda D. Nez, Ilena M. Norton, Douglas K. Novins, Theresa O'Nell, Heather D. Orton, Carlette J. Randall, Angela Sam, James H. Shore, Sylvia G. Simpson, Paul Spicer, and Lorette L. Yazzie.

  • Design, conduct of study, data collection, and original data management and analyses were supported by National Institute of Mental Health grants R01 MH48174 (S. M. Manson and J. Beals, principal investigators [PIs]) and P01 MH42473 (S. M. Manson, PI). Data analyses and interpretation specific to this manuscript as well as preparation, review, and approval were supported by R01 MH073965 (J. Beals, PI) and R01 MH075831 (C. Kaufman, PI).

  • AI-SUPERPFP would not have been possible without the significant contributions of many people. The following interviewers, computer/data management, and administrative staff supplied energy and enthusiasm for an often difficult job: Anna E. Barón, Antonita Begay, Amelia T. Begay, Cathy A. E. Bell, Phyllis Brewer, Nelson Chee, Mary Cook, Helen J. Curley, Mary C. Davenport, Rhonda Wiegman Dick, Marvine D. Douville, Pearl Dull Knife, Geneva Emhoolah, Fay Flame, Roslyn Green, Billie K. Greene, Jack Herman, Tamara Holmes, Shelly Hubing, Cameron R. Joe, Louise F. Joe, Cheryl L. Martin, Jeff Miller, Robert H. Moran Jr., Natalie K. Murphy, Melissa Nixon, Ralph L. Roanhorse, Margo Schwab, Jennifer Settlemire, Donna M. Shangreaux, Matilda J. Shorty, Selena S. S. Simmons, Wileen Smith, Tina Standing Soldier, Jennifer Truel, Lori Trullinger, Arnold Tsinajinnie, Jennifer M. Warren, Intriga Wounded Head, Theresa (Dawn) Wright, Jenny J. Yazzie, and Sheila A. Young. We would also like to acknowledge the contributions of the Methods Advisory Group: Margarita Alegria, Evelyn J. Bromet, Dedra Buchwald, Peter Guarnaccia, Steven G. Heeringa, Ronald Kessler, R. Jay Turner, and William A. Vega. Finally, we thank the tribal members who so generously answered all the questions asked of them.

Correspondence concerning this article should be addressed to Janette Beals, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Nighthorse Campbell Native Health Building, MS F800, 13055 E. 17th Ave., Room 333, Aurora, CO 80045-0508. E-mail: jan.beals@ucdenver.edu

Abstract

Posttraumatic stress disorder (PTSD) has been found to be more common among American Indian populations than among other Americans. A complex diagnosis, the assessment methods for PTSD have varied across epidemiological studies, especially in terms of the trauma criteria. Here, we examined data from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP) to estimate the lifetime prevalence of PTSD in two culturally distinct American Indian reservation communities, using two formulas for calculating PTSD prevalence. The AI-SUPERPFP was a cross-sectional probability sample survey conducted between 1997 and 2000. Southwest (n = 1,446) and Northern Plains (n = 1,638) tribal members living on or near their reservations, aged 15–57 years at time of interview, were randomly sampled from tribal rolls. PTSD estimates were derived based on both the single worst and 3 worst traumas. Prevalence estimates varied by ascertainment method: single worst trauma (lifetime: 5.9% to 14.8%) versus 3 worst traumas (lifetime, 8.9% to 19.5%). Use of the 3-worst-event approach increased prevalence by 28.3% over the single-event method. PTSD was prevalent in these tribal communities. These results also serve to underscore the need to better understand the implications for PTSD prevalence with the current focus on a single worst event.

Traditional and Simplified Chinese Abstracts by AsianSTSS

標題:在兩個美國印弟安保育區族群中創傷後壓力症的流行率

撮要:創傷後壓力症(PTSD)在美國人中較常見於印弟安裔人。但流行病學研究上由於PTSD為一複雜診斷,而且評核方法亦隨不同研究而異,尤其是關於創傷的定義。所以我們選取了美國印弟安醫療服務使用者的精神病流行學,風險及保護因素研究計劃(AI-SUSERPFP)來估計在兩個文化不同的美國印弟安保育社區中PTSD的終身發病率,其中使用兩個不同的程式去計算。AI-SUSERPFP 為在1997–2000年進行的一個橫斷面概率樣本調查。從部落名册中隨機抽樣了15–57歲居住在西南(N = 1,446)和北部(N = 1,638)平原的部族人士。從單一最重和三個嚴重創傷中得出PTSD估值。發病率估值依不同確認方法而異:單一最重創傷(終身:5.9%至14.8%)比對三個嚴重創傷(終身:8.9%至19.5%)。使用三個嚴重創傷事件方法比單一事件增多28.3%發病率。在這些部落社區中,PTSD是普遍的。本研究結果對現行聚焦單一嚴重事件的PTSD發病率有更深層次的理解。

标题:在两个美国印弟安保育区族群中创伤后压力症的流行率

撮要:创伤后压力症(PTSD)在美国人中较常见于印弟安裔人。但流行病学研究上由于PTSD为一复杂诊断,而且评核方法亦随不同研究而异,尤其是关于创伤的定义。所以我们选取了美国印弟安医疗服务使用者的精神病流行学,风险及保护因素研究计划(AI-SUSERPFP)来估计在两个文化不同的美国印弟安保育小区中PTSD的终身发病率,其中使用两个不同的程序去计算。AI-SUSERPFP 为在1997–2000年进行的一个横断面概率样本调查。从部落名册中随机抽样了15–57岁居住在西南(N = 1,446)和北部(N = 1,638)平原的部族人士。从单一最重和三个严重创伤中得出PTSD估值。发病率估值依不同确认方法而异:单一最重创伤(终身:5.9%至14.8%)比对三个严重创伤(终身:8.9%至19.5%)。使用三个严重创伤事件方法比单一事件增多28.3%发病率。在这些部落小区中,PTSD是普遍的。本研究结果对现行聚焦单一严重事件的PTSD发病率有更深层次的理解。

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