Benjet C, Bromet E, Karam E G, Kessler R C, McLaughlin K A, Ruscio A M, Shahly V, Stein D J, Petukhova M, Hill E, Alonso J, Atwoli L, Bunting B, Bruffaerts R, Caldas-de-Almeida J M, de Girolamo G, Florescu S, Gureje O, Huang Y, Lepine J P, Kawakami N, Kovess-Masfety Viviane, Medina-Mora M E, Navarro-Mateu F, Piazza M, Posada-Villa J, Scott K M, Shalev A, Slade T, ten Have M, Torres Y, Viana M C, Zarkov Z, Koenen K C
Department of Epidemiology and Psychosocial Research,Instituto Nacional de Psiquiatría Ramón de la Fuente,Mexico City,Mexico.
Department of Psychiatry,Stony Brook University School of Medicine,New York,NY,USA.
Psychol Med. 2016 Jan;46(2):327-43. doi: 10.1017/S0033291715001981. Epub 2015 Oct 29.
Considerable research has documented that exposure to traumatic events has negative effects on physical and mental health. Much less research has examined the predictors of traumatic event exposure. Increased understanding of risk factors for exposure to traumatic events could be of considerable value in targeting preventive interventions and anticipating service needs.
General population surveys in 24 countries with a combined sample of 68 894 adult respondents across six continents assessed exposure to 29 traumatic event types. Differences in prevalence were examined with cross-tabulations. Exploratory factor analysis was conducted to determine whether traumatic event types clustered into interpretable factors. Survival analysis was carried out to examine associations of sociodemographic characteristics and prior traumatic events with subsequent exposure.
Over 70% of respondents reported a traumatic event; 30.5% were exposed to four or more. Five types - witnessing death or serious injury, the unexpected death of a loved one, being mugged, being in a life-threatening automobile accident, and experiencing a life-threatening illness or injury - accounted for over half of all exposures. Exposure varied by country, sociodemographics and history of prior traumatic events. Being married was the most consistent protective factor. Exposure to interpersonal violence had the strongest associations with subsequent traumatic events.
Given the near ubiquity of exposure, limited resources may best be dedicated to those that are more likely to be further exposed such as victims of interpersonal violence. Identifying mechanisms that account for the associations of prior interpersonal violence with subsequent trauma is critical to develop interventions to prevent revictimization.
大量研究表明，接触创伤性事件会对身心健康产生负面影响。而对创伤性事件接触的预测因素进行研究的则少得多。深入了解创伤性事件接触的风险因素，对于针对性地开展预防干预措施以及预测服务需求可能具有重要价值。
对来自六大洲24个国家的普通人群进行调查，共有68894名成年受访者参与，评估他们对29种创伤性事件类型的接触情况。通过交叉列表分析患病率差异。进行探索性因素分析，以确定创伤性事件类型是否可聚类为可解释的因素。开展生存分析，以研究社会人口学特征和既往创伤性事件与后续接触之间的关联。
超过70%的受访者报告经历过创伤性事件；30.5%的人接触过四种或更多种。目睹死亡或重伤、亲人意外死亡、被抢劫、遭遇危及生命的车祸以及经历危及生命的疾病或受伤这五种类型占所有接触情况的一半以上。接触情况因国家、社会人口学特征和既往创伤性事件史而异。已婚是最一致的保护因素。接触人际暴力与后续创伤性事件的关联最为强烈。
鉴于创伤性事件接触几乎无处不在，有限的资源可能最好用于那些更有可能再次接触创伤性事件的人群，比如人际暴力的受害者。确定既往人际暴力与后续创伤之间关联的机制，对于制定预防再次受害的干预措施至关重要。
