Posttraumatic stress disorder associated with unexpected death of a loved one: Cross-national findings from the world mental health surveys

on behalf of the WHO World Mental Health Survey Collaborators

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Unexpected death of a loved one (UD) is the most commonly reported traumatic experience in cross-national surveys. However, much remains to be learned about posttraumatic stress disorder (PTSD) after this experience. The WHO World Mental Health (WMH) survey initiative provides a unique opportunity to address these issues. Methods: Data from 19 WMH surveys (n = 78,023; 70.1% weighted response rate) were collated. Potential predictors of PTSD (respondent sociodemographics, characteristics of the death, history of prior trauma exposure, history of prior mental disorders) after a representative sample of UDs were examined using logistic regression. Simulation was used to estimate overall model strength in targeting individuals at highest PTSD risk. Results: PTSD prevalence after UD averaged 5.2% across surveys and did not differ significantly between high-income and low-middle income countries. Significant multivariate predictors included the deceased being a spouse or child, the respondent being female and believing they could have done something to prevent the death, prior trauma exposure, and history of prior mental disorders. The final model was strongly predictive of PTSD, with the 5% of respondents having highest estimated risk including 30.6% of all cases of PTSD. Positive predictive value (i.e., the proportion of high-risk individuals who actually developed PTSD) among the 5% of respondents with highest predicted risk was 25.3%. Conclusions: The high prevalence and meaningful risk of PTSD make UD a major public health issue. This study provides novel insights into predictors of PTSD after this experience and suggests that screening assessments might be useful in identifying high-risk individuals for preventive interventions.

Original languageEnglish (US)
Pages (from-to)315-326
Number of pages12
JournalDepression and Anxiety
Volume34
Issue number4
DOIs
StatePublished - Apr 1 2017

Fingerprint

Post-Traumatic Stress Disorders
Health Surveys
Mental Health
Mental Disorders
Global Health
Wounds and Injuries
Spouses
Surveys and Questionnaires
Public Health
Logistic Models

Keywords

  • cross-national
  • epidemiology
  • international
  • life events/stress
  • PTSD
  • trauma

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Posttraumatic stress disorder associated with unexpected death of a loved one : Cross-national findings from the world mental health surveys. / on behalf of the WHO World Mental Health Survey Collaborators.

In: Depression and Anxiety, Vol. 34, No. 4, 01.04.2017, p. 315-326.

Research output: Contribution to journalArticle

on behalf of the WHO World Mental Health Survey Collaborators. / Posttraumatic stress disorder associated with unexpected death of a loved one : Cross-national findings from the world mental health surveys. In: Depression and Anxiety. 2017 ; Vol. 34, No. 4. pp. 315-326.
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abstract = "Background: Unexpected death of a loved one (UD) is the most commonly reported traumatic experience in cross-national surveys. However, much remains to be learned about posttraumatic stress disorder (PTSD) after this experience. The WHO World Mental Health (WMH) survey initiative provides a unique opportunity to address these issues. Methods: Data from 19 WMH surveys (n = 78,023; 70.1{\%} weighted response rate) were collated. Potential predictors of PTSD (respondent sociodemographics, characteristics of the death, history of prior trauma exposure, history of prior mental disorders) after a representative sample of UDs were examined using logistic regression. Simulation was used to estimate overall model strength in targeting individuals at highest PTSD risk. Results: PTSD prevalence after UD averaged 5.2{\%} across surveys and did not differ significantly between high-income and low-middle income countries. Significant multivariate predictors included the deceased being a spouse or child, the respondent being female and believing they could have done something to prevent the death, prior trauma exposure, and history of prior mental disorders. The final model was strongly predictive of PTSD, with the 5{\%} of respondents having highest estimated risk including 30.6{\%} of all cases of PTSD. Positive predictive value (i.e., the proportion of high-risk individuals who actually developed PTSD) among the 5{\%} of respondents with highest predicted risk was 25.3{\%}. Conclusions: The high prevalence and meaningful risk of PTSD make UD a major public health issue. This study provides novel insights into predictors of PTSD after this experience and suggests that screening assessments might be useful in identifying high-risk individuals for preventive interventions.",
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AU - King, Andrew

AU - Petukhova, Maria

AU - Aguilar-Gaxiola, Sergio

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AU - Lepine, Jean Pierre

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AU - Piazza, Marina

AU - Posada-Villa, Jose

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N2 - Background: Unexpected death of a loved one (UD) is the most commonly reported traumatic experience in cross-national surveys. However, much remains to be learned about posttraumatic stress disorder (PTSD) after this experience. The WHO World Mental Health (WMH) survey initiative provides a unique opportunity to address these issues. Methods: Data from 19 WMH surveys (n = 78,023; 70.1% weighted response rate) were collated. Potential predictors of PTSD (respondent sociodemographics, characteristics of the death, history of prior trauma exposure, history of prior mental disorders) after a representative sample of UDs were examined using logistic regression. Simulation was used to estimate overall model strength in targeting individuals at highest PTSD risk. Results: PTSD prevalence after UD averaged 5.2% across surveys and did not differ significantly between high-income and low-middle income countries. Significant multivariate predictors included the deceased being a spouse or child, the respondent being female and believing they could have done something to prevent the death, prior trauma exposure, and history of prior mental disorders. The final model was strongly predictive of PTSD, with the 5% of respondents having highest estimated risk including 30.6% of all cases of PTSD. Positive predictive value (i.e., the proportion of high-risk individuals who actually developed PTSD) among the 5% of respondents with highest predicted risk was 25.3%. Conclusions: The high prevalence and meaningful risk of PTSD make UD a major public health issue. This study provides novel insights into predictors of PTSD after this experience and suggests that screening assessments might be useful in identifying high-risk individuals for preventive interventions.

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