Trauma exposure and stress‐related disorders in African‐American women with diabetes mellitus

• Type of Material: Article
• Authors: H. Drew Dixon, Emory University; Vasiliki Michopoulos, Emory University; Rachel L. Gluck, Emory University; Hadrian Mendoza, Emory University; Adam P. Munoz, Emory University; Joseph G. Wilson, Emory University; Abigail Powers, Emory University; Ann Schwartz, Emory University; Guillermo Umpierrez, Emory University; Charles Gillespie, Emory University
• Language: English
• Date: 2020-01-14
• Publisher: Wiley
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1002/edm2.111
• Title of Journal or Parent Work: Endocrinology, Diabetes and Metabolism
• Volume: 3
• Issue: 2
• Grant/Funding Information: This study was supported by MH099211 (CFG), HD085850 (VM), 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.
• Keywords: glycaemic control; trauma exposure; PTSD; MDD; diabetes
• Research Categories: Health Sciences, Public Health; Health Sciences, Nutrition

Abstract

Objective The purpose of the study was to assess demographic features, rates of trauma exposure, prevalence of post‐traumatic stress and depressive symptoms in a group of urban, low‐income, African‐American women with type 1 or type 2 diabetes mellitus. Research Design and Methods We conducted a survey of (n = 290) low‐income, African‐American women seeking care in the diabetes clinic of an urban hospital and collected data on the demographic characteristics, childhood and nonchildhood abuse trauma exposure, and the severity of post‐traumatic stress and depressive symptoms using the Post‐traumatic Stress Disorder (PTSD) Symptom Scale (PSS) and the Beck Depression Inventory (BDI). In a subset of women with type 2 diabetes (n = 96), we assessed haemoglobin A1c to examine the relationship between psychopathology and glycaemic control. Results Of the overall sample, 61.7% reported exposure to trauma in their lifetime, and 30.4% and 29.3% had current PTSD and MDD, respectively. Exposure to both childhood and nonchildhood abuse trauma was associated with an increased PTSD and depressive symptom severity (P's < .05). PTSD diagnosis, but not depression, was associated with increased haemoglobin A1c (P = .002). Conclusions These data document high levels of trauma exposure, PTSD and depressive symptoms in diabetic African‐American women treated in a specialty clinic of an urban hospital setting. Furthermore, these data indicate that the presence of PTSD is negatively associated with glycaemic control.