Trauma exposure and stress-related disorders in a large, urban, predominantly African-American, female sample

• Type of Material: Article
• Authors: Rachel L Gluck, Emory University; Georgina Hartzell, Emory University; Hayley D Dixon, Emory University; Vasiliki Michopoulos, Emory University; Abigail Powers, Emory University; Jennifer Stevens, Emory University; Negar Fani, Emory University; Sierra Carter, Emory University; Ann Schwartz, Emory University; Tanja Jovanovic, Emory University; Kerry Ressler, Emory University; Bekh Bradley, Emory University; Charles Gillespie, Emory University
• Language: English
• Date: 2021-05-15
• Publisher: SPRINGER WIEN
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature
• Final Published Version (URL): http://dx.doi.org/10.1007/s00737-021-01141-4
• Title of Journal or Parent Work: ARCHIVES OF WOMENS MENTAL HEALTH
• Volume: 24
• Issue: 6
• Start Page: 893
• End Page: 901
• Grant/Funding Information: This study was supported by MH069884, HD071982, MH100122, MH099211, HD085850, MH115174, AG062334, the Atlanta Clinical Translational Science Institute, the NIH National Centers for Research Resources (M01 RR00039), the Woodruff Health Sciences IT Division (UL1 TR000424), and the Emory University General Clinical Research Center at Grady Hospital. The funding sources had no role in the design and conduct of the study; collection, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
• Keywords: Trauma; ASSOCIATION; VIOLENCE; Life Sciences & Biomedicine; Depression; VALIDITY; COMMUNITY; ADVERSE CHILDHOOD EXPERIENCES; Science & Technology; BURDEN; SYMPTOMS; ABUSE; Women; PTSD; Child abuse; RISK; Psychiatry

Abstract

The current study investigated the relationship between trauma exposure and psychopathology in a sample of predominately African-American women of low socioeconomic status (SES). Women (N = 7430) were recruited from medical clinics at two large public hospitals in Atlanta, GA, from 2005 to 2017. Women were assessed for sociodemographics, life-course trauma burden, posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) utilizing self-report and structured clinical interview assessments. The effects of trauma exposure on current and lifetime PTSD and MDD were examined. Ninety-one percent of women reported trauma exposure, 83% reported a monthly household income of less than $2000, and 41% reported a history of arrest. Regarding psychiatric diagnoses, 30.8% met the criteria for probable MDD, and 32.3% met the criteria for probable PTSD. History of childhood abuse and total lifetime trauma significantly increased PTSD and depressive symptoms with additional incremental trauma exposure. PTSD and depressive symptom scores (95% CI) increased from 5.5 (5.0–6.1) and 8.4 (7.9–9.0) in the no trauma group to 20.8 (20.1–21.5) and 20.4 (19.7–21.2), respectively, in those exposed to four or more types of trauma. These results show high rates of adult and childhood trauma exposure, PTSD, MDD, and an additive effect of lifetime trauma exposure on the development of PTSD and MDD in a sample of low SES African-American women. These findings bring light to the high psychiatric symptom burden in this population and call for increased availability of interventions to address symptoms as well as policies aimed at reducing trauma exposure across the lifespan.