Differences in PTSD Domains Between Survivors of War-Type and Not War-Type Traumatic Events

Background and Purpose:  With the increase of combat-related traumatic events the treatment and prevention of post-traumatic stress disorder (PTSD) has moved to the forefront.  Studies have found correlations in avoidance, hyperarousal, and re-experiencing PTSD domain structures of groups who experienced similar traumatic events.  Evidence of significant correlations in PTSD symptomology between survivors of similar trauma begs the question: Does PTSD symptomology for those who have experienced different types of trauma look differently? 

Methods:  This study is a secondary analysis of the Collaborative Psychiatric Epidemiology Surveys (CPES) (2001-2003).  Three logistic regression models were used to determine whether the type of traumatic event (war-type or not war-type) contributed to meeting PTSD domain criteria.  The first step of each model examines the influence of type of trauma.  The second step adds distress caused by reactions to the trauma, gender, years since trauma occurrence, age at trauma, and total number of traumatic events experienced to the model.  The final step includes interactions between type of trauma and the aforementioned variables.  A complex sample plan was used to weight the data due to stratified multistage cluster sampling. 

Results:  The study consisted of n = 1202 participants, with n = 133 reporting a war-type trauma (11.06%).  Significant differences between type of trauma groups were found on meeting re-experiencing PTSD criteria (χ² = 4.478, p<.05) and number of years since the trauma occurred (t= 2.277, 1200, p<.05).  The first step of the avoidance model was not significant (F = .317, p>.05).  The second step of the model was significant overall (F = 7.579, p<.001), with all factors except type of trauma significantly contributing to the model.  No variables or interactions in the third step were significant.  The hyperarousal model found similar results, with the first step also not significantly contributing to the model.  Significant contributors in the second step included distress caused by to reactions to the trauma, years since trauma occurrence, age at the time of trauma and total number of traumatic events experienced.  The first step of the re-experiencing model was not significant.  Significant contributors in the second step included distress caused by reactions to the trauma, years since trauma occurrence, and total number of traumatic events experienced.  The total number of traumatic events was significant in the final step, with participants being 44.1 times more likely to meet re-experiencing PTSD criteria.  Notably, the total number of traumatic events was significant in the second step of each model, with people who experienced more traumatic events being 17.4 (avoidance), 18.6 (hyperarousal) and 39.0 (re-experiencing) times more likely to meet PTSD criteria.

Conclusions and Implications:  Type of traumatic event experienced did not contribute to whether participants met PTSD domain criteria.  Future studies should consider distress caused by reactions to trauma, gender, age at time of trauma, and total number of traumatic events experienced when examining PTSD symptomology.  Social workers treating persons with PTSD should take into account the total number of traumatic events experienced, and how these events affect current avoidance, hyperarousal, and re-experiencing symptomology.