The associations of earlier trauma exposures and history of mental disorders with PTSD after subsequent traumas.

Mol Psychiatry
Authors
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.Molecular Psychiatry advance online publication, 19 September 2017; doi:10.1038/mp.2017.194.

Year of Publication
2017
Journal
Mol Psychiatry
Date Published
2017 Sep 19
ISSN
1476-5578
DOI
10.1038/mp.2017.194
PubMed ID
28924183
PubMed Central ID
PMC5858954
Links
Grant list
R01 DA016558 / DA / NIDA NIH HHS / United States
R01 MH093612 / MH / NIMH NIH HHS / United States
R03 TW006481 / TW / FIC NIH HHS / United States
R01 MH069864 / MH / NIMH NIH HHS / United States
R01 MH061905 / MH / NIMH NIH HHS / United States
U01 MH060220 / MH / NIMH NIH HHS / United States
R01 MH070884 / MH / NIMH NIH HHS / United States
T32 MH017119 / MH / NIMH NIH HHS / United States
R01 MH059575 / MH / NIMH NIH HHS / United States
R13 MH066849 / MH / NIMH NIH HHS / United States