目标:创伤后应激障碍(PTSD)影响全球数百万人。虽然直接暴露于创伤事件和创伤后应激障碍之间的关系是公认的,间接创伤暴露对PTSD的影响尚不清楚.同样,尚不清楚直接和间接创伤的累积暴露在PTSD风险中起什么作用。
方法:该研究使用休斯顿创伤和恢复研究的数据,在2020-2021年进行,并在2017年哈维飓风期间对居住在休斯顿的1,167个人进行了随机抽样。参与者被问及他们与哈维飓风和随后的COVID-19大流行有关的经历。暴露被归类为直接或间接创伤,符合《精神疾病诊断和统计手册》(DSM-5)第五版中规定的标准。还计算了累积暴露量。
结果:在参与者中,12.6%的人正在经历当前的PTSD。与Harvey相关的直接[OR=3.18,95%CI1.85,5.46]和间接[OR=1.91,95%CI1.05,3.46]之间存在显着关联。以及完全调整模型中COVID和PTSD风险导致的直接[OR=2.13,95%CI1.20,3.77]和间接[OR=1.69,95%CI0.93,3.09]创伤。Further,发现飓风哈维和COVID-19的累积创伤暴露与创伤后应激障碍的风险之间存在显著关联,考虑直接[OR=2.53,95%CI1.36,4.70]和间接暴露[OR=2.79,95%CI1.47,5.28]。
结论:我们的研究为暴露于大规模灾难和创伤后应激障碍的直接和间接创伤之间的联系提供了支持。此外,我们表明,累积暴露于多个大规模事件会增加PTSD的风险.这凸显了将一系列暴露作为创伤后应激障碍风险的重要性,特别是在灾难和广泛的人口暴露于这些事件的时代。
OBJECTIVE: Posttraumatic Stress Disorder (PTSD) affects millions of people worldwide. While the relationship between direct exposure to traumatic events and PTSD is well-established, the influence of indirect trauma exposure on PTSD remains unclear. It is similarly unclear what role cumulative exposure to direct and indirect traumas play in the risk of PTSD.
METHODS: The study uses data from the Houston Trauma and Recovery Study, conducted on 2020-2021, and involved a random sampling of 1,167 individuals residing in Houston during Hurricane Harvey in 2017. Participants were asked about their experiences related to both Hurricane Harvey and the subsequent COVID-19 pandemic. Exposures were categorized as direct or indirect traumas, in line with the criteria delineated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Cumulative exposures were also calculated.
RESULTS: Among participants, 12.6% were experiencing current PTSD. There were significant associations between both direct [OR = 3.18, 95% CI 1.85, 5.46] and indirect [OR = 1.91, 95% CI 1.05, 3.46] traumas related to Harvey, as well as direct [OR = 2.13, 95% CI 1.20, 3.77] and indirect [OR = 1.69, 95% CI 0.93, 3.09] traumas due to COVID and the risk of PTSD in fully adjusted models. Further, significant associations were found between the cumulative exposure to traumas from both Hurricane Harvey and COVID-19 and the risk of PTSD, considering both direct [OR = 2.53, 95% CI 1.36, 4.70] and indirect exposures [OR = 2.79, 95% CI 1.47, 5.28].
CONCLUSIONS: Our study offers support for connections between exposure to both direct and indirect traumas stemming from large-scale disasters and PTSD. Moreover, we show that cumulative exposures to multiple large-scale events increase the risk of PTSD. This highlights the importance of the consideration of a range of exposures as risks for PTSD, particularly in a time of compounding disasters and broad population exposures to these events.