Abstract：
Cumulative trauma is usually devastating and can lead to severe psychological consequences, including posttraumatic stress disorder (PTSD). Exposure to various types of traumas, particularly during childhood, can be even more deleterious than the sheer number of events experienced. This epidemiological study is the first to investigate the impact of discrete childhood traumatic exposure on the risk of developing lifetime PTSD in a representative sample of the general population of the two biggest Brazilian cities. Participants were aged between 15 and 75 years old, living in São Paulo and Rio de Janeiro, Brazil, who had experienced traumatic events (N = 3,231). The PTSD diagnosis was assessed using the DSM-IV criteria through the version 2.1 of Composite International Diagnostic Interview. To operationalize childhood cumulative trauma, we considered the sum of 15 different childhood trauma categories that occurred before PTSD onset. The final multivariate logistic regression model indicated a strong relationship between the number of discrete types of childhood traumas and the likelihood of the lifetime PTSD development. The lifetime PTSD risk increased 28 % with each different type of childhood trauma when adjusted by confounds. Our study strengthens the evidence associating childhood cumulative trauma to increased lifetime PTSD risk.
摘要：
累积创伤通常是毁灭性的，会导致严重的心理后果，包括创伤后应激障碍（PTSD）。暴露于各种类型的创伤，特别是在童年时期，可能比经历的事件数量更有害。这项流行病学研究是第一个在巴西两个最大城市的一般人群的代表性样本中调查离散的儿童创伤暴露对终生PTSD风险的影响。参与者年龄在15至75岁之间，住在圣保罗和里约热内卢,巴西,谁经历过创伤事件（N=3,231）。通过综合国际诊断访谈2.1版，使用DSM-IV标准评估PTSD诊断。为了实施童年累积创伤，我们考虑了PTSD发病前发生的15种不同的儿童创伤类别的总和.最终的多变量逻辑回归模型表明，儿童期创伤的离散类型数量与终生PTSD发展的可能性之间存在很强的关系。通过混淆调整后，每种不同类型的儿童创伤的终生PTSD风险增加了28％。我们的研究加强了将童年累积创伤与终生PTSD风险增加相关联的证据。
