The association between number and type of traumatic life experiences and physical conditions in a nationally representative sample

Gen Hosp Psychiatry. 2014 Jan-Feb;36(1):26-32. doi: 10.1016/j.genhosppsych.2013.06.003. Epub 2013 Oct 29.


Objective: Posttraumatic stress disorder (PTSD) is significantly and positively associated with several physical conditions. We aimed to examine whether the nature and number of trauma(s) experienced may be related to physical conditions using a population-based sample.

Methods: Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34,653; age 20 years and older). Participants indicated lifetime trauma experiences and physical conditions experienced over the past year. Multiple logistic regressions examined the association between type and number of trauma(s) and physical conditions.

Results: After adjusting for sociodemographics, Axis I and II mental disorders, and all other trauma, injurious and witnessing trauma were significantly associated with all the assessed physical conditions. Psychological trauma was associated with cardiovascular and gastrointestinal diseases, diabetes and arthritis. Natural disaster/terrorism was associated with cardiovascular disease, gastrointestinal disease and arthritis only. Finally, combat-related trauma and other trauma were not positively associated with any physical condition. Our results also suggested a dose-response relationship between number of traumatic events and physical conditions.

Conclusion: These data suggest that the impact of certain types and number of traumas may differ with respect to their relationship with physical health problems independent of PTSD.

Keywords: Comorbidity; Epidemiology; Physical health; Trauma.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Adult Survivors of Child Abuse / statistics & numerical data*
  • Arteriosclerosis / epidemiology
  • Arthritis / epidemiology*
  • Cardiovascular Diseases / epidemiology*
  • Comorbidity
  • Diabetes Mellitus / epidemiology*
  • Disasters / statistics & numerical data*
  • Female
  • Gastrointestinal Diseases / epidemiology*
  • Humans
  • Hypertension / epidemiology
  • Life Change Events
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity / epidemiology*
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress, Psychological / epidemiology*
  • Terrorism / statistics & numerical data*
  • United States / epidemiology
  • Young Adult