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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

Published online by Cambridge University Press:  29 March 2010

A. L. Roberts ,
S. E. Gilman ,
J. Breslau ,
N. Breslau  and
K. C. Koenen
A. L. Roberts
Affiliation:
Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA
S. E. Gilman
Affiliation:
Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
J. Breslau
Affiliation:
Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, CA, USA
N. Breslau
Affiliation:
Department of Epidemiology, Michigan State University, East Lansing, MI, USA
K. C. Koenen*
Affiliation:
Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, USA Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA Harvard Center on the Developing Child, Cambridge, MA, USA
*
*Address for correspondence: K. C. Koenen, Ph.D., Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Avenue, Kresge Building, 7th Floor, Boston, MA 02115, USA. (Email: kkoenen@hsph.harvard.edu)
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Abstract

Background

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.

Method

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.

Results

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%).

Conclusions

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.

Keywords

Ethnic groupspost-traumatic stress disorderracetraumatic eventstreatment-seeking
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 1 , January 2011 , pp. 71 - 83
Copyright
Copyright © Cambridge University Press 2010

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