PREVALENCE AND CHARACTERISTICS OF TRAUMA AND POSTTRAUMATIC-STRESS-DISORDER IN A SOUTHWESTERN AMERICAN-INDIAN COMMUNITY

Objective: High rates of violence and trauma in many American Indian c ommunities have been reported. The authors investigated the relationsh ip between both the frequency and type of traumatic events and the pre valence of posttraumatic stress disorder (PTSD) in a South-western Ame rican Indian tribe. Method: A structured psychiatric interview and the Traumatic Events Booklet were administered to a subset of 247 tribal members from an overall study population of 582. Subjects were recruit ed from the community on the basis of membership in pedigrees, and not by convenience. DSM-III-R diagnoses were assigned by consensus after the interviews were evaluated blindly by independent raters. Results: The prevalence of lifetime PTSD was 21.9% (N=54), and 81.4% of the sub jects (N=201) had experienced at least one traumatic event apiece. The most predictive factor for lifetime PTSD among women was the experien ce of physical assault, and for men the most predictive factors were a history of combat and having experienced more than 10 traumatic event s. Conclusions: In this South-western American Indian community, the p revalences of lifetime PTSD and of exposure to a traumatic event were higher than in the general U.S. population. However, the nearly 4:1 ra tio of subjects who reported at least one traumatic event to those wit h PTSD diagnoses is similar to findings from studies of non-Indians. I ndividuals with a history of multiple traumatic events (66.0%, N=163) had a significantly higher risk of developing PTSD. Chronic and multip le trauma did not preclude the identification of acute and discrete tr aumatic events that resulted in PTSD.