1. PTSD prevalence (https://link.springer.com/article/10.1186/s13033-018-0229-8)

1. Background: Post-traumatic stress disorder (PTSD) is a common mental health condition among survivors of road traffic accidents (RTAs), but little research has been conducted in low and middle-income countries like Ethiopia. The study aimed to assess the prevalence and factors associated with PTSD in this context.

2. Methods: A cross-sectional study was conducted in May 2016 at public hospitals in Addis Ababa, Ethiopia. The PTSD Checklist-Specific version (PCL-S) questionnaire was used to assess participants. A total of 492 RTA survivors were included in the study, selected through systematic sampling.

3. Results: 

   – The prevalence of PTSD was found to be 22.8% among survivors of road traffic accidents.

   – Key factors significantly associated with PTSD were:

     – Being female (females were more than twice as likely as males to develop PTSD).

     – Poor social support.

     – Having depression.

     – Duration since the accident (those assessed 1–3 months after the accident were more likely to develop PTSD than those assessed after more than 3 months).

4. Conclusion: PTSD was found to be prevalent among RTA survivors in Ethiopia, especially in women, those with poor social support, and those with co-occurring depression. This suggests a need for early screening and intervention for PTSD among RTA survivors.

The study emphasizes the importance of integrating mental health services into primary care for early diagnosis and treatment of PTSD in low-resource settings.

1. DSM-5 PTSD prev (https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0059236&type=printable)

1. Objective: The study conducted a systematic review of the literature to examine the longitudinal course of post-traumatic stress disorder (PTSD) in DSM-5 defined trauma-exposed populations, with a focus on distinguishing between intentional and non-intentional traumatic events.

2. Methods: The review analyzed 58 articles, representing 35 unique populations, which examined PTSD prevalence at two or more time points within 12 months of a traumatic event. The traumatic events were categorized as either intentional (e.g., assault, war) or unintentional (e.g., natural disasters, accidents).

3. Key Findings:

   – **PTSD Prevalence**: The overall prevalence of PTSD decreased over time, from an average of 28.8% at 1 month to 17.0% at 12 months. However, the course of PTSD varied depending on the type of trauma.

   – Intentional vs. Non-Intentional Trauma: PTSD prevalence decreased over time for non-intentional traumatic events (e.g., motor vehicle accidents), while it increased for intentional trauma (e.g., assaults or combat). The median PTSD prevalence for non-intentional trauma dropped from 30.1% at 1 month to 14.0% at 12 months, while for intentional trauma, it increased from 11.8% to 23.3%.

   – **PTSD Trajectories**: Of those exposed to intentional trauma, about 37.1% developed PTSD within the first year. Among those diagnosed with PTSD, approximately 34.8% remitted after 3 months, while 39.1% followed a chronic course. Only 3.5% of new PTSD cases appeared after the initial 3 months.

4. Implications: The study emphasizes that the type of trauma (intentional vs. non-intentional) significantly influences the prevalence and trajectory of PTSD. This knowledge is critical for public health planning and treatment interventions, as intentional traumas tend to result in a more prolonged and chronic course of PTSD.

5. Conclusions: The findings underscore the importance of understanding the different courses of PTSD based on the type of trauma, which can help inform resource allocation and treatment strategies. Additionally, more longitudinal studies are needed to better understand PTSD trajectories over time, particularly for non-intentional trauma events

1. Prevalence, Demographic, and Clinical Correlates of Likely PTSD (https://www.mdpi.com/1660-4601/18/12/6227)

Objective: The study aimed to evaluate the prevalence and factors associated with likely post-traumatic stress disorder (PTSD) in subscribers of the Text4Hope service during the COVID-19 pandemic.

Methodology: The study involved a cross-sectional survey administered to subscribers of Text4Hope, a free mental health support service, over a three-month period during the pandemic. The PTSD Checklist for DSM-5 (PCL-5) was used to assess symptoms. Demographic and clinical data were also collected.

Prevalence of PTSD:

• The study found a high prevalence of likely PTSD (46.8%) among the survey respondents, with the highest prevalence reported among individuals identifying as “other gender” (66.7%).

Risk Factors for PTSD:

• Several factors were associated with an increased likelihood of PTSD:

• Fear of contracting COVID-19.

• History of depression before the pandemic.

• Receiving counseling during the pandemic.

• Living in rented accommodations.

• Identifying as Indigenous.

Protective Factors:

• Subscribers who received absolute support from family and friends had lower odds of developing PTSD. Social support was identified as a key protective factor in reducing PTSD symptoms.

Sociodemographic Correlates:

• Subscribers who were unemployed, self-isolated or quarantined, or lacked sufficient support from employers also exhibited higher likelihoods of PTSD.

Clinical Correlates:

• History of mental health diagnoses, such as anxiety or depression, and prior use of psychotropic medications were significant predictors of likely PTSD.

Conclusions:

• The study highlights the mental health impact of the COVID-19 pandemic and the importance of targeted mental health interventions, particularly for vulnerable groups like Indigenous people, those with pre-existing mental health conditions, and those with limited social support. It suggests public health campaigns should include mental health support strategies during pandemics.

1.  Predictors of the development and maintenance of posttraumatic stress disorder following a motor vehicle accident: a path analytic approach

1. Definition and Overview of PTSD: Post-traumatic Stress Disorder (PTSD) is described as a mental health condition triggered by a terrifying event, either experiencing it or witnessing it. PTSD is characterized by intrusive thoughts, avoidance of trauma-related stimuli, alterations in cognition and mood, and hyperarousal.

2. Prevalence Rates: The prevalence of PTSD varies significantly depending on the nature of the traumatic event. Studies suggest that the overall prevalence decreases from 28.8% at one month post-trauma to 17.0% at 12 months. However, intentional trauma (e.g., violence) tends to result in a higher prevalence of PTSD compared to non-intentional trauma (e.g., accidents).

3. Course and Trajectory of PTSD: PTSD can follow different trajectories. Approximately 34.8% of those diagnosed remit within three months, while about 39.1% have a chronic course. New cases of PTSD post-trauma are rare after the first three months, accounting for only 3.5% of cases.

4.Comorbidities: PTSD often coexists with other mental health conditions, such as depression and substance use disorders, particularly alcohol abuse. Comorbid conditions are common and contribute to the complexity of treatment and recovery.

5. Factors Influencing PTSD Severity: The severity of PTSD symptoms is influenced by pre-trauma factors (e.g., previous mental health issues), the nature of the trauma, and post-trauma factors (e.g., social support, coping mechanisms). Additionally, physical disability and emotional distress following trauma are significant predictors of long-term PTSD outcomes.

6. Clinical Implications: The findings underscore the importance of early interventions, particularly for individuals exposed to intentional trauma. Understanding the specific risk factors and trajectories of PTSD can aid in developing targeted public health interventions to support those affected by trauma.

F) Risk factor/gender race (https://www.researchgate.net/profile/Brittany-Hall-Clark/publication/306381344_RacialEthnic_Differences_in_Symptoms_of_Posttraumatic_Stress_Disorder/links/5ec54a33a6fdcc90d6872ff5/Racial-Ethnic-Differences-in-Symptoms-of-Posttraumatic-Stress-Disorder.pdf) 

Objective: The article reviews racial and ethnic differences in the prevalence and symptom expression of PTSD among major racial/ethnic groups in the U.S. (African Americans, Hispanics/Latinos, and Asians/Asian Americans). The review also considers cultural factors such as trauma exposure, acculturation, and experiences of racism.

PTSD Prevalence:

• African Americans have a higher prevalence of PTSD compared to non-Latino Whites.

• Latinos, especially those exposed to trauma, also show higher conditional risk for PTSD.

• Asian Americans report lower levels of PTSD prevalence but face unique cultural factors in symptom expression.

Cultural and Sociopolitical Factors:

• Cultural and racial experiences, including discrimination and socioeconomic status, significantly influence PTSD symptomatology. African Americans and Latinos face higher trauma exposure due to socioeconomic conditions, while Asians report different trauma types, such as political violence.

Racial Differences in Trauma Exposure:

• African Americans are more likely to experience interpersonal violence and community violence.

• Latinos face significant trauma from violence and natural disasters.

• Asians, although reporting lower trauma exposure, encounter political violence in their countries of origin.

Cultural Variations in Symptom Expression:

• PTSD symptoms manifest differently across ethnic groups, with African Americans more prone to dissociation and psychotic symptoms, Latinos to avoidance and dissociation, and Asian Americans often somatizing symptoms.

• Cultural expressions of PTSD, such as ataque de nervios in Latinos, also affect diagnosis and treatment.

Social and Mental Health Impact:

• Racial/ethnic minorities experience unique stressors like racism and acculturation stress, which may exacerbate PTSD symptoms.

• Discrimination can lead to PTSD symptoms, with hypervigilance and negative cognitions prevalent in African Americans, while Latinos may experience delayed onset PTSD.

Implications for Treatment:

• The review highlights the need for culturally sensitive assessment and treatment approaches, including addressing language barriers and considering the impact of racism in diagnosis.

• There is a need for more research into the effects of cultural factors, such as acculturation, on PTSD symptoms and treatment outcomes.

H) Gender/race risk factor cont…. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6870874/pdf/nihms-1542588.pdf) 

Objective and Methodology:

• The study aimed to evaluate the risk of exposure to potentially traumatic events (PTEs) and the diagnosis of PTSD among different genders, stratified by race/ethnicity.

• Data from three national studies (Collaborative Psychiatric Epidemiology Surveys, CPES) involving 13,649 participants were used, employing regression analyses to examine the relationship between PTEs, PTSD, and gender across racial/ethnic groups.

Findings:

• Adjusting for sociodemographic variables and other factors, women of White, African-American, and Afro-Caribbean descent had higher odds of PTSD compared to men in their respective groups. Gender differences were not noted among Latinos or Asians.

• Factors like mental health comorbidity, social support, and type and frequency of PTE exposure varied significantly by gender and race/ethnicity.

• Women were more likely to report exposure to sexual-type PTEs, while men reported more exposure to accidents, combat, and physical assaults.

• Social and cultural factors play a critical role in the risk and diagnosis of PTSD, suggesting that these elements should be considered in future PTSD assessments and treatments.

Conclusions:

• The risk of PTE exposure and PTSD diagnosis differs significantly by gender and racial/ethnic background.

• The study underscores the importance of considering social, cultural, and contextual factors when assessing PTSD risks across different demographics.