Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States.
Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States.
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DOI：
10.1017/s0033291710000401
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发表时间：
2011-01
影响因子：
6.9
通讯作者：
Koenen, K. C.
中科院分区：
文献类型：
--
作者：
Roberts, A. L.;Gilman, S. E.;Breslau, J.;Breslau, N.;Koenen, K. C.
为了确定与创伤后应激障碍(PTSD)相关的种族/民族差异的来源，我们比较了创伤暴露、暴露于创伤中的人患创伤后应激障碍的风险，以及美国普通人群中白人、黑人、西班牙裔和亚洲人寻求治疗的情况。对2004-2005年全国酒精及相关疾病流行病学调查(NESARC)中34653名成年受访者的结构化诊断性访谈数据进行了分析。创伤后应激障碍的终生患病率在黑人中最高(8.7%)，在西班牙裔和白人中居中(7.0%和7.4%)，在亚洲人中最低(4.0%)。创伤风险的差异因事件类型而异。白人比其他群体更有可能遭受任何创伤，更有可能得知亲人受到创伤，以及意外死亡，但黑人和西班牙裔儿童虐待儿童的风险更高，主要是目睹家庭暴力，亚裔、黑人男性和西班牙裔女性比白人更有可能发生与战争有关的事件。在那些暴露在创伤中的人中，在调整了创伤暴露的特征后，黑人的创伤后应激障碍风险略高于白人[调整后的优势比(AOR)1.22]，而亚洲人的PTSD风险低于白人(AOR 0.67)。所有少数族裔群体寻求创伤后应激障碍治疗的可能性低于白人(AOR范围：0.39-0.61)，患有创伤后应激障碍的少数族裔寻求治疗的比例不到一半(范围：32.7-42.0%)。当创伤后应激障碍影响到美国的种族/少数民族时，它通常不会得到治疗。治疗方面的巨大差异表明，需要对可获得和文化敏感的治疗选择进行投资。
To identify sources of race/ethnic differences related to post-traumatic stress disorder (PTSD), we compared trauma exposure, risk for PTSD among those exposed to trauma, and treatment-seeking among Whites, Blacks, Hispanics and Asians in the US general population. Data from structured diagnostic interviews with 34 653 adult respondents to the 2004–2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analysed. The lifetime prevalence of PTSD was highest among Blacks (8.7%), intermediate among Hispanics and Whites (7.0% and 7.4%) and lowest among Asians (4.0%). Differences in risk for trauma varied by type of event. Whites were more likely than the other groups to have any trauma, to learn of a trauma to someone close, and to learn of an unexpected death, but Blacks and Hispanics had higher risk of child maltreatment, chiefly witnessing domestic violence, and Asians, Black men, and Hispanic women had higher risk of war-related events than Whites. Among those exposed to trauma, PTSD risk was slightly higher among Blacks [adjusted odds ratio (aOR) 1.22] and lower among Asians (aOR 0.67) compared with Whites, after adjustment for characteristics of trauma exposure. All minority groups were less likely to seek treatment for PTSD than Whites (aOR range: 0.39–0.61), and fewer than half of minorities with PTSD sought treatment (range: 32.7–42.0%). When PTSD affects US race/ethnic minorities, it is usually untreated. Large disparities in treatment indicate a need for investment in accessible and culturally sensitive treatment options.