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Am J Psychiatry 1995; 152:529-535
Copyright © 1995 by American Psychiatric Association
Risk factors for PTSD-related traumatic events: a prospective analysis
N Breslau, GC Davis and P Andreski
Department of Psychiatry, Henry Ford Health Sciences Center, Detroit, MI 48202.
OBJECTIVE: The authors previously identified suspected risk factors for
traumatic events related to posttraumatic stress disorder (PTSD) on the
basis of data gathered retrospectively. In this study, they tested that
model prospectively. METHOD: A random sample of 1,200 persons was drawn
from all 21- to 30-year-old members of a large health maintenance
organization. In 1989, 1,007 of these persons were interviewed, and
suspected risk factors were measured. In 1992, 979 were reinterviewed, and
the 3-year incidence of exposure to traumatic events was ascertained.
RESULTS: Nineteen percent of the sample reported traumatic events during
the 3-year follow-up. A history of past exposure to traumatic events
signaled an increase in the liability to exposure during follow-up,
independent of suspected risk factors. Two predictors of exposure,
neuroticism and extroversion, identified retrospectively, also predicted
exposure prospectively. The odds for exposure among males and persons with
less than a college education were marginally significant. Early misconduct
and a family history of psychiatric disorder-predictors of exposure in the
retrospective data-were not significant predictors at 3-year follow-up.
Blacks had a higher incidence of exposure during follow-up than whites. An
exploratory reanalysis suggested that the discrepancy between the
retrospective and prospective results may be explained by the inclusion of
childhood exposure in the lifetime retrospective inquiry. CONCLUSIONS: The
assumption that PTSD-related traumatic events are random phenomena was
unsupported. Among young adults, those with less education, blacks, and
those with high neuroticism and extroversion scores are more likely than
others to be exposed to traumatic events and are thus at greater risk for
PTSD.
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