Prevalence, risk, and correlates of posttraumatic stress disorder across ethnic and racial minority groups in the United States

Med Care. 2013 Dec;51(12):1114-23. doi: 10.1097/MLR.0000000000000007.

Abstract

Objectives: We assess whether posttraumatic stress disorder (PTSD) varies in prevalence, diagnostic criteria endorsement, and type and frequency of potentially traumatic events (PTEs) among a nationally representative US sample of 5071 non-Latino whites, 3264 Latinos, 2178 Asians, 4249 African Americans, and 1476 Afro-Caribbeans.

Methods: PTSD and other psychiatric disorders were evaluated using the World Mental Health-Composite International Diagnostic Interview (WMH-CIDI) in a national household sample that oversampled ethnic/racial minorities (n=16,238) but was weighted to produce results representative of the general population.

Results: Asians have lower prevalence rates of probable lifetime PTSD, whereas African Americans have higher rates as compared with non-Latino whites, even after adjusting for type and number of exposures to traumatic events, and for sociodemographic, clinical, and social support factors. Afro-Caribbeans and Latinos seem to demonstrate similar risk to non-Latino whites, adjusting for these same covariates. Higher rates of probable PTSD exhibited by African Americans and lower rates for Asians, as compared with non-Latino whites, do not appear related to differential symptom endorsement, differences in risk or protective factors, or differences in types and frequencies of PTEs across groups.

Conclusions: There appears to be marked differences in conditional risk of probable PTSD across ethnic/racial groups. Questions remain about what explains risk of probable PTSD. Several factors that might account for these differences are discussed, as well as the clinical implications of our findings. Uncertainty of the PTSD diagnostic assessment for Latinos and Asians requires further evaluation.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • African Americans / psychology
  • African Americans / statistics & numerical data
  • Aged
  • Asian Americans / psychology
  • Asian Americans / statistics & numerical data
  • Ethnicity / psychology
  • Ethnicity / statistics & numerical data*
  • Female
  • Hispanic or Latino / psychology
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Mental Disorders / ethnology
  • Middle Aged
  • Patient Acuity
  • Prevalence
  • Racial Groups / psychology
  • Racial Groups / statistics & numerical data*
  • Risk Factors
  • Social Support
  • Socioeconomic Factors
  • Stress Disorders, Post-Traumatic / ethnology*
  • United States / epidemiology
  • Young Adult