Prevalence, Risk, and Correlates of Posttraumatic Stress Disorder Across Ethnic and Racial Minority Groups in the United States

• Published in: Medical care Vol. 51; no. 12; pp. 1114 - 1123
• Main Authors: Alegría, Margarita, Fortuna, Lisa R., Lin, Julia Y., Norris, Fran H., Gao, Shan, Takeuchi, David T., Jackson, James S., Shrout, Patrick E., Valentine, Anne
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 01-12-2013; by Lippincott Williams & Wilkins; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adolescent; Adult; African Americans; African Americans - psychology; African Americans - statistics & numerical data; Aged; Asian Americans - psychology; Asian Americans - statistics & numerical data; Asians; Continental Population Groups - psychology; Continental Population Groups - statistics & numerical data; Correlation analysis; Disease risks; Ethnic Groups - psychology; Ethnic Groups - statistics & numerical data; Female; Hispanic Americans - psychology; Hispanic Americans - statistics & numerical data; Hispanics; Humans; Male; Mental Disorders - ethnology; Mental health; Middle Aged; Military psychiatry; Minority & ethnic groups; Patient Acuity; Post traumatic stress disorder; Prevalence; Risk assessment; Risk Factors; Sex education; Social Support; Socioeconomic Factors; Stress Disorders, Post-Traumatic - ethnology; Symptomatology; United States - epidemiology; Violence; Young Adult; United States; United States > US
• ISSN: 0025-7079; 1537-1948
• DOI: 10.1097/MLR.0000000000000007

Objectives: We assess whether posttraumatic stress disorder (PTSD) varies in prevalence, diagnostic criteria endorsement, and type and frequency of potentially traumatic events (PTEs) among a nationally representative US sample of 5071 non-Latino whites, 3264 Latinos, 2178 Asians, 4249 African Americans, and 1476 Afro-Caribbeans. Methods: PTSD and other psychiatric disorders were evaluated using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) in a national household sample that oversampled ethnic/racial minorities (n = 16,238) but was weighted to produce results representative of the general population. Results: Asians have lower prevalence rates of probable lifetime PTSD, whereas African Americans have higher rates as compared with non-Latino whites, even after adjusting for type and number of exposures to traumatic events, and for sociodemographic, clinical, and social support factors. Afro-Caribbeans and Latinos seem to demonstrate similar risk to non-Latino whites, adjusting for these same covariates. Higher rates of probable PTSD exhibited by African Americans and lower rates for Asians, as compared with non-Latino whites, do not appear related to differential symptom endorsement, differences in risk or protective factors, or differences in types and frequencies of PTEs across groups. Conclusions: There appears to be marked differences in conditional risk of probable PTSD across ethnic/racial groups. Questions remain about what explains risk of probable PTSD. Several factors that might account for these differences are discussed, as well as the clinical implications of our findings. Uncertainty of the PTSD diagnostic assessment for Latinos and Asians requires further evaluation.