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Trauma and victims: epidemiology of post-traumatic stress disorder

Published online by Cambridge University Press:  11 October 2011

Giovanni de Girolamo  and
Elisabetta Marchiori
Giovanni de Girolamo*
Affiliation:
Divisione di Salute Mentale, Azienda USL Città di Bologna, Bologna
Elisabetta Marchiori
Affiliation:
Istituto di Clinica Psichiatrica, Università di Padova, Padova
*
Indirizzo per la corrispondenza: Dr. G. de Girolamo, Servizio di Salute Mentale, Azienda USL Città di Bologna, Viale Pepoli 5, 40123 Bologna. Fax (+39) 051-6492322
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Summary

Objectives - To present a comprehensive review of the studies assessing the frequency of PTSD in the general population, in clinical populations and among subjects at risk. Design - An extensive search was made using the Excerpta Medica Psychiatry CD-ROM 1980-1993 (October). Using post-traumatic stress disorder as a key word, a total of 1,057 papers published in this timespan were retrieved. A further search was made using the same key word with MEDLINE CD-ROM 1988-1993. A manual search was also performed for all issues of the Journal of Traumatic Stress. Results - A total of 135 studies meeting inclusion criteria were selected for this review. Almost two thirds (n = 86, 64%) of these studies were carried out in the United States; only 8 (6%) studies have been carried out in developed countries. The sample size ranges from a low of 11 subjects up to a high of 22,463 subjects. The mean sample size is 500 and the median is 108. In terms of assessment methods, in one third (n = 45, 33%) of the studies the investigators used a PTSD symptom checklist (either self- administered or administered by a clinician), based on DSM criteria, to generate a PTSD diagnosis. In more than in one third of the studies (n = 44, 33%) of the studies, a structured interview was administered (e.g., the DIS, the SCID, the SADS), while in the remaining surveys the diagnostic evaluation was based either on an un- structured clinical assessment or on the administration of other specific assessment instruments (e.g., M-PTSD, IES, SCL-90-R or others). In 77 studies (57%) the investigators based their assessment on DSM-III diagnostic criteria for PTSD, whereas in 55 studies (41 %) DSM-III-R criteria were employed. Prevalence rates are discussed separately for the different population groups. Conclusions - There has been a remarkable increase in the number and quality of epidemiological studies on PTSD over the past decade. A substantial amount of information is now available about the frequency of PTSD among different population groups and among at risk subjects, and about risk factors, common symptom patterns, and natural history of this disorder. However, a number of important limitations of these studies are to be noted and should be addressed by future research efforts.

Riassunto

Scopo - Presentare una esaustiva review degli studi riguardanti l'epidemiologia del DPTS condotti nella popolazione generale, tra i soggetti a rischio, e, infine, tra gruppi clinicamente selezionati. Disegno - Attraverso Excepta Medica Psychiatry CD-ROM 1980-1993 (ottobre), utilizzando come parola chiave «Post-Traumatic Stress Disorder», sono stati identificati 1.057 articoli pubblicati nel periodo considerate Sono stati anche consultati altri data base della letteratura medica (MEDLINE CD-ROM 1988-1993); è stata quindi operata una ricerca manuale su tutti i numeri del Journal of Traumatic Stress. Risultati - In totale, 135 lavori che hanno soddisfatto i criteri di inclusione prescelti sono stati inclusi nella review. I due terzi (n = 86, 64%) di queste ricerche sono state condotte negli USA. Solo 8 (6%) sono le indagini effettivamente realizzate nei paesi del Terzo Mondo. L'ampiezza del campione varia da un minimo di 11 soggetti, numero riscontrato in due studi, sino ad un massimo di 22.436, per un campione medio di 500 e mediano di 108. Per quanto attiene ai metodi di valutazione, in un terzo degli studi (n = 45, 33%), i ricercatori hanno impiegato un questionario (auto- o etero- somministrato). In un altro terzo delle ricerche elencate (n = 44, 33%) e stata somministrata un'intervista strutturata (la DIS, la SCID, o la SADS), mentre nei rimanenti studi la valutazione diagnostica si è basata o su una procedura clinica non strutturata, o sulla somministrazione di altri strumenti specifici dai quali è possibile inferire una diagnosi di DPTS (M-PTSD, IES, SCL-90-R,o pochi altri). In 77 studi (57%) i ricercatori hanno basato la loro valutazione sui criteri diagnostici propri del DSM-III, mentre in altri 55 (41%) su quelli del DSM-III-R. La prevalenza del DPTS e analizzata quindi separatamente per le diverse popolazioni studiate. Conclusioni - Nell'arco di soli 13 anni, a partire cioe dalla definizione di criteri diagnostici operazionali ben definiti per il DPTS, sono stati condotti numerosi studi volti ad indagare la prevalenza, i fattori di rischio, la storia naturale, il decorso e l' esito di questo disturbo tra campioni diversi di popolazioni a rischio; inoltre, anche il livello qualitativo di queste ricerche, per quanto attiene alia sofisticazione metodologica, si è accresciuto sensibilmente in un tempo tutto sommato breve. Molte aree, pero', restano tuttora inesplorate, ed inoltre appare imperativo avviare ricerche estensive tra le popolazioni dei paesi in via di sviluppo, maggiormente esposte a disastri naturali o provocati dall'uomo.

Keywords

traumiepidemiologiadisturbo post-traumatico da stressfattori di rischiotraumaepidemiologypost-traumatic stress disorderrisk factors
Type
Articles
Information
Epidemiology and Psychiatric Sciences , Volume 4 , Issue 2 , August 1995 , pp. 110 - 144
Copyright
Copyright © Cambridge University Press 1995

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References

Bibliografia

Abenhaim, L., Dab, W. & Salmi, L.R. (1992). Study of civilian victims of terrorist attacks in France (1982-1987). Journal ofClinical Epidemiology 45, 103–109.CrossRefGoogle ScholarPubMed
Aghabeigi, B., Feinmann, C. & Harris, M. (1992). Prevalence of post traumatic stress disorder in patients with chronic idiopathic facial pain. British Journal of Oral and Maxillofacial Surgery 30, 360–364.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed.). APA: Washington, DC.Google Scholar
American Psychiatric Association (1986). Diagnostic and Statistical Manual of Mental Disorders (3rd ed. revised). APA: Washington, DC.Google Scholar
Amick, McMullan A., Kilpatrick, D.G. & Resnick, H.S. (1991).Homicide as a risk factor for PTSD among surviving family members. Behaviour Modification 15, 545–559.CrossRefGoogle Scholar
Basoglu, M., Paker, M., Ozmen, E., Marks, I., Incesu, C., Sahin, D. & Sarimurat, N. (1994). Psychological effects of torture: a comparison of tortured with nontortured political activists in Turkey. American Journal of Psychiatry 151, 76–81.Google Scholar
Bauer, M., Priebe, S., Haring, B. & Adamczak, K. (1993). Long-term sequelae of political imprisonment in East Germany. Journal of Nervous and Mental Disease 181, 257–262.Google Scholar
Bell, P., Kee, M., Lougrey, G.C., Roddy, R.J. & Curran, P.S. (1988). Post traumatic stress in Northern Ireland. Ada Psychiatrica Scandinavica 11, 166–169.Google Scholar
Benedikt, R.A. & Kolb, L.C. (1986). Preliminary findings on chronic pain and posttraumatic stress disorder. American Journal of Psychiatry 143, 908–910.Google ScholarPubMed
Blake, D.D., Keane, T.M., Wine, P.R., Mora, C., Taylor, K.L. & Lyons, J.A. (1990). Prevalence of PTSD symptoms in combat veterans seeking medical treatment. Journal of Traumatic Stress 3, 15–27.CrossRefGoogle Scholar
Blow, F.C., Cook, C.A.L., Booth, B.M., Falcon, S.P., Friedman, M.J. (1992). Age related psychiatric comorbidities and level of functioning in alcoholic veterans seeking outpatient treatment. Hospital and Community Psychiatry 43, 990–995.Google ScholarPubMed
Boon, S. & Draijer, N. (1993). Multiple personality disorder in The Netherlands: a clinical investigation of 71 patients. American Journal of Psychiatry 150, 489–494.Google ScholarPubMed
Bownes, I.T., O'Gorman, E.C. & Sayers, A. (1991). Assault characteristics and post-traumatic stress disorder in rape victims. Acta Psychiatrica Scandinavica 83, 27–30.Google Scholar
Brawman-Mintzer, O., Lydiard, B., Emmanuel, N., Payeur, R., Johnson, M., Roberts, J., Jarrell, M.P. & Ballenger, J.C (1993). Psychiatric comorbidity in patients with generalized anxiety disorder. American Journal of Psychiatry 150, 1216–1218.Google Scholar
Breslau, N. & Davis, G.C. (1987). Post-traumatic stress disorder: the etiologic specificity of wartime stressors. American Journal of Psychiatry 144, 578–583.Google ScholarPubMed
Breslau, N., Davis, G.C, Andreski, P. & Peterson, E. (1991). Traumatic events and post-traumatic stress disorder in an urban population of young adults. Archives of General Psychiatry 48, 216–222.CrossRefGoogle Scholar
Brom, D.Kleber, R.J. & Hofman, M.C. (1993). Victims of traffic accidents: incidence and prevention of post-traumatic stress disorder. Clinical Psychology 49, 131–140.3.0.CO;2-2>CrossRefGoogle ScholarPubMed
Brooks, N & McKinlay, W. (1992). Mental health consequences of the Lockerbie disaster. Journal of Traumatic Stress 5, 527–543.CrossRefGoogle Scholar
Burge, S.K. (1988). Post-traumatic stress disorder in victims of rape. Journal of Traumatic Stress 1, 193–209.Google Scholar
Burges-Watson, I.P. (1993). Post-traumatic stress disorder in Australian prisoners of the Japanese: a clinical study. Australian and New Zealand Journal of Psychiatry 27, 20–29.CrossRefGoogle Scholar
Buy dens Branchey, L., Noumair, D. & Branchey, M. (1990). Duration and intensity of combat exposure and post-traumatic stress disorder in Vietnam veterans. Journal of Nervous and Mental Disease 178, 582–587.CrossRefGoogle Scholar
Caldwell, M.F. (1992). Incidence of PTSD among staff victims of patient violence. Hospital and Community Psychiatry 43, 838–839.Google ScholarPubMed
Callen, K.E., Reaves, M.E., Maxwell, M.J. & McFarland, B.H. (1985). Vietnam veterans in the general hospital. Hospital and Community Psychiatry 36, 150–153.Google Scholar
Canino, G., Bravo, M., Rubio-Stipec, M. & Woodbury, M. (1990). The impact of disaster on mental health: prospective and retrospective analyses. International Journal of Mental Health 19, 51–69.CrossRefGoogle Scholar
Card, J.J. (1987). Epidemiology of PTSD in a national cohort of Vietnam veterans. Journal of Clinical Psychology 43, 6–17.3.0.CO;2-X>CrossRefGoogle Scholar
Carlson, E.B. & Kogan, R. (1991). Trauma experiences, post-traumatic stress, dissociation, and depression in Cambodian refugees. A merican Journal of Psychiatry 148, 1548–1551.Google Scholar
Centers for Disease Control Vietnam Experience Study (1988). Health status of Vietnam veterans, I: Psychosocial characteristics. Journal of the American Medical Association 259, 2701–2707.CrossRefGoogle Scholar
Cervantes, R.C., Salgado de Snyder, V.N. & Padilla, A.M.P. (1989). Post-traumatic stress in immigrants from Central America and Mexico. Hospital and Community Psychiatry 40, 615–619.Google ScholarPubMed
Chemtob, C.M., Bauer, G.B., Neller, G., Hamada, R., Glisson, C. & Stevens, V. (1990). Post-traumatic stress disorder among special forces Vietnam veterans. Military Medicine 155, 16–20.Google Scholar
Collins, J.J. & Bailey, S.L. (1990). Traumatic stress disorder and violent behavior. Journal of Traumatic Stress 3, 203–220.CrossRefGoogle Scholar
Conyer, R.C.T., Sepulveda, Amor J., Medina, Mora M.E., Caraveo, J. & De La Fuente, J.R. (1987). Prevalencia del sindrome de estres postraumatico en la poblacion sobreviviente a un desastre natural. Salud Publica Mexicana 29, 406–411.Google Scholar
Cottier, L.B., Compton, W.M. III, Mager, D., Spitznagel, E.L. & Janca, A. (1992). Post-traumatic stress disorder among substance users from the general population. American Journal of Psychiatry 149, 664–670.Google Scholar
Creamer, M. (1989). Post-traumatic stress disorder: some diagnostic and clinical issues. Australian and New Zealand Journal of Psychiatry 23, 517–522.Google Scholar
Crocq, M.A., Hein, K.D., Duval, F. & Macher, J.P. (1991). Severity of the prisoner of war experience and post-traumatic stress disorder. European Psychiatry 6, 39–45.CrossRefGoogle Scholar
Curran, P.S., Bell, P., Murray, A., Loughrey, G., Roddy, R. & Rocke, L.G. (1990). Psychological consequences of the Enniskillen bombing. British Journal of Psychiatry 156, 479–482.CrossRefGoogle ScholarPubMed
Cuzzolaro, M. & Frighi, L. (1991). Reazioni Umane alle Catastrofi. Aspetti Psicosociali e di Igiene Mentale. Fondazione Adriano Olivetti: Torino.Google Scholar
Dahl, S. (1989). Acute response to rape: a PTSD variant. Ada Psychiatrica Scandinavica, Supplementum 80, 56–62.CrossRefGoogle Scholar
Davidson, J. & Smith, R. (1990). Traumatic experiences in psychiatric outpatients. Journal of Traumatic Stress 3, 459–475.CrossRefGoogle Scholar
Davidson, J.R.T. & Fairbank, J.A. (1993). The epidemiology of post-traumatic stress disorder. In Post-traumatic Stress Disorder. DSM-IV and Beyond (ed. Davidson, R.T. and Foa, E.B.), pp. 147–172. APA: Washington, DC.Google Scholar
Davidson, J.R.T., Hughes, D., Blazer, D.G. & George, L.K. (1991). Post-traumatic stress disorder in the community: an epidemiological study. Psychological Medicine 21, 713–721.CrossRefGoogle ScholarPubMed
de Girolamo, G. (1993). International perspectives in the treatment and prevention of post-traumatic stress disorders. In International Handbook of Traumatic Stress Syndromes (ed. Wilson, J. and Raphael, B.), pp. 935–946. Plenum Press: New York.Google Scholar
de Girolamo, G. (1994). Primary health care for refugees and displaced people. In Amidst Peril and Pain: The Mental Health and Wellbeing of the World's Refugees (ed. Marsella, T., Bornemann, T., Ekblad, S. and Orley, J.), pp. 263–274. APA: Washington, DC.Google Scholar
De Groen, J.H.M., Op den Velde, W., Hovens, J.E., Falger, P.R.J., Schouten, E.G.W. & Van Duijn, H. (1993). Snoring and anxiety dreams. Sleep 16, 35–36.Google ScholarPubMed
den Veld, W.O., Falger, P.R.J., Hovens, J.E., de Groen, J.H.M., Lasschuit, L.J., Van Dijn, H. & Schouten, E.G.W. (1993). Post-traumatic stress disorder in Dutch resistance veterans from World War Il. In International Handbook of Traumatic Stress Syndromes (ed. Wilson, J. and Raphael, B.), pp. 219–230. Plenum Press: New York.Google Scholar
Durham, T.W., McCammon, S.L. & Allison, E.J. Jr (1985). The psychological impact of disaster on rescue personnel. Annals of Emergency Medicine 14, 664–668.CrossRefGoogle ScholarPubMed
Eberly, R.E. & Engdahl, B.E. (1991). Prevalence of somatic and psychiatric disorder among former prisoners of war. Hospital and Community Psychiatry 42, 807–813.Google ScholarPubMed
Ersland, S., Weisaeth, L. & Sund, A. (1989). The stress upon rescuers involved in an oil rig disaster. «Alexander Kielland» 1980. Ada Psychiatrica Scandinavica, Supplementum 80, 38–49.Google Scholar
Fairley, M., Langeluddecke, P. & Tennant, C. (1986). Psychological and physical morbidity in the aftermath of a cyclone. Psychological Medicine 16, 671–676.Google Scholar
Famularo, R., Kinscherff, R. & Fenton, T. (1992). Psychiatric diagnoses of abusive mothers. A preliminary report. Journal of Nervous and Mental Disease 180, 658–661.CrossRefGoogle ScholarPubMed
Farmer, R., Tranah, T., O'Donnell, I. & Catalan, J. (1992). Railway suicide: the psychological effects on drivers. Psychological Medicine 22, 407–414.CrossRefGoogle ScholarPubMed
Faustman, W.O. & White, P.A. (1989). Diagnostic and psychopharmacologic treatment characteristics of 536 inpatients with PTSD. Journal of Nervous and Mental Disease 177, 154–159.Google Scholar
Feinstein, A. (1993). A prospective study of victims of physical trauma. In International Handbook of Traumatic Stress Syndromes (ed. Wilson, J. and Raphael, B.), pp. 157–164. Plenum Press: New York.Google Scholar
Fierman, E.J., Hunt, M.F., Pratt, L.A., Warshaw, M.G., Yonkers, K.A., Peterson, L.G., Epstein-Kaye, T.M. & Norton, H.S. (1993). Trauma and post-traumatic stress disorder in subjects with anxiety disorders. American Journal of Psychiatry 150, 1872–1874.Google Scholar
Fisher, N. & Jacoby, R (1992). Psychiatric morbidity in bus crews following violent assault: A follow-up study. Psychological Medicine 22, 685–693.CrossRefGoogle ScholarPubMed
Frye, S. & Stockton, R.A. (1982). Discriminant analysis of posttraumatic stress disorder among a group of Viet Nam veterans. American Journal of Psychiatry 139, 52–56.Google Scholar
Gersons, B.P.R. (1989). Intensive treatment of post-traumatic stress disorder: experiences with policemen. Tijdschr Psychiatry 33,244–261.Google Scholar
Goldberg, J., True, W.R., Eisen, S.A. & Henderson, W.G. (1990). A twin study of the effects of the Vietnam war on post-traumatic stress disorder. Journal of the American Medical Association 263, 1227–1232.Google Scholar
Green, B.L. (1991). Evaluating the effects of disasters. Journal of Consulting and Clinical Psychology 3, 538–546.Google Scholar
Green, B.L. (1993). Identifying survivors at risk. Trauma and stressors across events. In International Handbook of Traumatic Stress Syndromes (ed. Wilson, J. and Raphael, B.), pp. 135–144. Plenum Press: New York.CrossRefGoogle Scholar
Green, B.L., Wilson, J.P. & Lindy, J.D. (1985). Conceptualizing post-traumatic stress disorder: a psychosocial framework. In Trauma and Its Wake (ed. Fingley, C.R.), pp. 53–69. BrunnerMazel: New York.Google Scholar
Green, B.L., Lindy, J.D., Grace, M.C. & Gleser, G.C. (1989). Multiple diagnosis in post-traumatic stress disorder. The role of war stressors. Journal of Nervous and Mental Disease 177, 329–335.Google Scholar
Green, B.L, Lindy, J.D., Grace, M.C. & Leonard, A.C. (1992a). Chronic post-traumatic stress disorder and diagnostic comorbidity in a disaster sample. Journal of Nervous and Mental Disease 180, 760–766.Google Scholar
Green, B.L., Lindy, J.D. & Grace, M.C. (1992b). Post-traumatic stress disorder: towards DSM-IV. Journal of Nervous and Mental Disease 173, 406–411.CrossRefGoogle Scholar
Haber-Schaim, N., Solomon, Z., Bleich, A. & Kottler, M. (1988). The prevalence of PTSD. New England Journal of Medicine 318, 1691.Google Scholar
Hauff, E. & Vaglum, P. (1993). Vietnamese boat refugees: the influence of war and flight traumatization on mental health on arrival in the country of resettlement. Ada Psychiatrica Scandinavica 88, 162–168.Google Scholar
Helzer, J.E., Robins, L.N. & McEvoy, L. (1987). Post-traumatic stress disorder in the general population: findings of the epidemiologic catchment area survey. New England Journal of Medicine 317, 1630–1634.Google Scholar
Hendin, H. & Haas, A.P. (1991). Suicide and guilt as manifestations of PTSD in Vietnam combat veterans. American Journal of Psychiatry 148, 586–591.Google Scholar
Hickling, E.J. & Blanchard, E.B. (1992). Post-traumatic stress disorder and motor vehicle accidents. Journal of Anxiety Disorders 6, 285–291.CrossRefGoogle Scholar
Hinton, W.L., Chen, Y.C.J., Du, N., Tran, C.G., Lu, F.G., Miranda, J. & Faust, S. (1993). DSM-III-R disorders in Vietnamese refugees. Prevalence and correlates. Journal of Nervous and Mental Disease 181, 113–122.Google Scholar
Hough, R.L., Vega, W., Valle, R., Kolody, B., Griswald del Castillo, R. & Tarke, H. (1990). Mental health consequences of the San Ysidro McDonald's massacre: a community study. Journal of Traumatic Stress 3, 71–93.Google Scholar
Houskamp, B.M. & Foy, D.W. (1991). The assessment of posttraumatic stress disorder in battered women. Journal of Interpersonal Violence 6, 368–376.CrossRefGoogle Scholar
Hryvniak, M.R. (1989). Concurrent psychiatric illness in inpatients with post-traumatic stress disorder. Military Medicine 154, 399–401.CrossRefGoogle ScholarPubMed
International Federation of Red Cross and Red Crescent Societies (1993). World Disasters Report 1993. Martinus Nijhoff: Dordrecht.Google Scholar
Jordan, B.K., Schlenger, W.E., Hough, R., Kulka, R.A., Weiss, p., Fairbank, J.A. & Marmar, C.R. (1991). Lifetime and current prevalence of specific psychiatric disorders among Vietnam veterans and controls. Archives of General Psychiatry 48, 207–215.Google Scholar
Keane, T.M. (1990). The epidemiology of post-traumatic stress disorder: some comments and concerns. PTSD Research Quarterly 1, 1–3.Google Scholar
Keane, T.M. & Penk, W.E.. (1988). The prevalence of PTSD. New England Journal of Medicine 318, 1690–1691.Google Scholar
Kemp, A., Rawlings, E.J. & Green, B.L. (1991). Post-traumatic stress disorder (PTSD) in battered women: a shelter sample. Journal of Traumatic Stress 4, 137–147.Google Scholar
Kidson, M.A., Douglas, J.C. & Holwill, B.J. (1993). Post-traumatic stress disorder in Australian World War II veterans attending a psychiatric outpatient clinic. Medical Journal of Australia 158, 563–566.CrossRefGoogle ScholarPubMed
Kilpatrick, D.G., Saunders, B.E., Amick-McMullan, A., Best, C.L., Veronen, L.J. & Resnick, H.S. (1989). Victim and crime factors associated with the development of crimerelated post-traumatic stress disorder. Behaviour Therapy 20, 199–214.CrossRefGoogle Scholar
Kinzie, J.D., Sack, W.H., Angell, R.H., Manson, S. & Rath, B. (1986). The psychiatric effects of massive trauma on Cambodian children: I. The children. Journal of the Academy of Child and Adolescent Psychiatry 25, 370–376.Google Scholar
Kinzie, J.D., Boehnlein, J.K., Leung, P.K., Moore, L.J., Riley, C. & Smith, D. (1990). The prevalence of post-traumatic stress disorder and its clinical significance among Southeast Asian refugees. American Journal of Psychiatry 147, 913–917.Google Scholar
Kluznik, J.C, Speed, N., Van-Valkenburg, C. & Magraw, R. (1986). Forty-year follow-up of United States prisoners of war. American Journal of Psychiatry 143, 1443–1446.Google Scholar
Korver, A.I.H. (1987). What is a disaster? Prehospitai and Disaster Medicine 2, 152–153.Google Scholar
Kozarick-Kovaclc, D., Folnegovic-Smalc, V. & Marusic, A. (1993). Psychological disturbances among 47 Croatian prisoners of war tortured in detention camps. Journal of American Medical Association 270, 575.Google Scholar
Kroll, J., Habenicht, M., Mackenzie, T., Yang, M., Chan, S., Vang, T., Nguyen, T., Ly, M., Phommasouvanh, B., Nguyen, H., Vang, Y., Souvannasoth, L. & Cabugao, R. (1989). Depression and post-traumatic stress disorder in Southeast Asian refugees. American Journal of Psychiatry 146, 1592–1597.Google Scholar
Kuch, K. & Cox, B.J. (1992). Symptoms of PTSD in 124 survivors of the Holocaust. American Journal of Psychiatry 149, 337–340.Google ScholarPubMed
Kulka, R.A., Schlenger, W.E., Fairbank, J.A., Hough, R.L., Jordan, B.K., Marmar, C.R. & Weiss, D.S. (1990). Trauma in the Vietnam War Generation. Brunner/Mazel: New York.Google Scholar
Lima, B.R., Pai, S., Santacruz, H. & Lozano, J. (1991a). Psychiatric disorders among poor victims following a major disaster: Armero, Colombia. Journal of Nervous and Mental Disease 179, 420–427.CrossRefGoogle Scholar
Lima, B.R., Pai, S., Caris, L., Haro, J.M., Lima, A.M., Toledo, V., Lozano, J. & Santacruz, H. (1991b). Psychiatric disorders in primary health care clinics one year after a major Latin American disaster. Stress Medicine 7, 25–32.CrossRefGoogle Scholar
Lindal, E. & Stefansson, J.G. (1993). The lifetime prevalence of anxiety disorders in Iceland as estimated by the US National Institute of Mental Health Diagnostic Interview Schedule. Acta Psychiatrica Scandinavica 88, 29–34.Google Scholar
Lindberg, F.H. & Distad, L.J. (1985). Post-traumatic stress disorders in women who experienced childhood incest. Child Abuse and Neglect 9, 329–334.Google Scholar
Long, N., Chamberlain, K. & Vincent, C. (1992). The health and mental health of New Zealand Vietnam war veterans with post-traumatic stress disorder. The New Zealand Medical Journal 105, 417–419.Google Scholar
Lopez, G., Piffaut, G. & Seguin, A. (1992). Prise en charge psychologique des victimes d'agressions sexuelles. A propos d'une enquete des UMJ, Paris (436 questionnaires). Psychologie Medicale 24, 286–288.Google Scholar
Madakasira, S. & O'Brien, K.F. (1987). Acute post-traumatic stress disorders in victims of a natural disaster. Journal of Nervous and Mental Disease 175, 286–290.Google Scholar
Maj, M., Starace, F., Crepet, P., Lobrace, S., Veltro, F., De Marco, F. & Kemali, D. (1989). Prevalence of psychiatric disorders among subjects exposed to a natural disaster. Ada Psychiatrica Scandinavica 79, 544–549.CrossRefGoogle ScholarPubMed
Malt, U. (1988). The longterm psychiatric consequences of accidental injury. A longitudinal study of 107 adults. British Journal of Psychiatry 153, 810–818.Google Scholar
Manolias, M.B. & Hyatt-Williams, A. (1993). Effects of post-shooting experiences on police-authorized firearms officers in the United Kingdom. In International Handbook of Traumatic Stress Syndromes (ed. Wilson, J. and Raphael, B.), pp. 385–394. Plenum Press: New York.Google Scholar
Marchiori, E., Borgheri, G., Pavan, L. (1993). L'abuso sessuale come problema di salute mentale: dalla «sindrome del trauma da stupro» al DSM-III-R. Quaderni Italiani di Psichiatria 12, 493–511.Google Scholar
Mayou, R., Bryant, B. & Duthie, R. (1993). Psychiatric consequences of road traffic accidents. British Medical Journal 307, 647–651.Google Scholar
McFall, M.E., MacKay, P.W. & Donovan, D.M. (1991). Combat related PTSD and psychosocial adjustment problems among substance abusing veterans. Journal of Nervous and Mental Disease 179, 33–38.Google Scholar
McFarlane, A.C. (1988). The phenomenology of post-traumatic stress disorders following a natural disaster. Journal of Nervous and Mental Disease 176, 22–29.Google Scholar
McFarlane, A.C. (1992). Avoidance and intrusion in post-traumatic stress disorder. Journal of Nervous and Mental Disease 180, 439–445.CrossRefGoogle Scholar
McGorry, P.D., Chanen, A., McCarthy, E., Van-Riel, R., McKenzie, D. & Singh, B.S. (1991). Post-traumatic stress disorder following recent onset psychosis. An unrecognized postpsychotic syndrome. Journal of Nervous and Mental Disease 179, 253–258.Google Scholar
McNally, R.J. & Lukach, B.M. (1992). Are panic attacks traumatic stressors? American Journal of Psychiatry 149, 824–826.Google Scholar
Mellman, T.A., Randolph, C.A., Brawman-Mintzer, O., Flores, L.P. & Milanes, F.J. (1992). Phenomenology and course of psychiatric disorders associated with combatrelated posttraumatic stress disorder. American Journal of Psychiatry 149, 1568–1574.Google Scholar
Mollica, R.F., Wyshak, G. & Lavelle, J. (1987). The psychological impact of war trauma and torture on Southeast Asian refugees. American Journal of Psychiatry 144, 1567–1572.Google Scholar
Mollica, R.F., Donelan, K., Tor, S., Lavelle, J., Elias, C., Frankel, M. & Blendon, R.J. (1993). The effect of trauma and confinement on functional health and mental health status of Cambodians living in Thailand-Cambodia border camps. Journal of the American Medical Association 270, 581–586.Google Scholar
Moore, L.J. & Bochnlein, J.K. (1991). Post-traumatic stress disorder, depression, and somatic symptoms in U.S. Mien patients. Journal of Nervous and Mental Disease 179, 728–733.Google Scholar
Newman, J.P. & Foreman, C. (1987). Presentation to the Society for Traumatic Stress. Baltimore, Maryland.Google Scholar
Norris, F.H. (1992). Epidemiology of trauma: frequency and impact of different potentially traumatic events on different demographic groups. Journal of Consulting and Clinical Psychology 60, 409–418.CrossRefGoogle ScholarPubMed
North, C.S. & Smith, E.M. (1992). Post-traumatic stress disorder among homeless men and women. Hospital and Community Psychiatry 43, 1010–1016.Google Scholar
North, C.S., Smith, E.M., McCool, R.E. & Shea, J.M. (1989a). Short-term psychopathology in eyewitnesses to mass murder. Hospital and Community Psychiatry 40, 1293–1295.Google Scholar
North, C.S., Smith, E.M., McCool, R.E. & Lightcap, P.E. (1989b). Acute postdisaster coping and adjustment. Journal of Traumatic Stress 2, 353–360.Google Scholar
North, C.S., Smith, E.M. & Spitznagel, E.L. (1994). Post-traumatic stress disorder in survivors of a mass shooting. American Journal of Psychiatry 151, 82–88.Google Scholar
O'Brien, L.S. & Hughes, S.J. (1991). Symptoms of post-traumatic stress disorder in Falklands veterans five years after the conflict. British Journal of Psychiatry 159, 135–141 1991.Google Scholar
Orner, R.J. (1993). Post-traumatic stress syndromes among British veterans of the Falklands war. In International Handbook of Traumatic Stress Syndromes (ed. Wilson, J. and Raphael, B.), pp. 305–310. Plenum Press: New York.Google Scholar
Palinkas, L.A., Petterson, J.S., Russell, J. & Downs, M.A. (1993). Community patterns of psychiatric disorders after the Exxon Valdez oil spill. American Journal of Psychiatry 150, 1517–1523.Google Scholar
Patterson, D.R., Carrigan, L., Questad, K.A. & Robinson, R. (1990). Post-traumatic stress disorder in hospitalized patients with burn injuries. Journal of Burn Care and Rehabilitation 11, 181–184.Google Scholar
Perez-Jimenez, J.P., Graell-Berna, M., Perez-Sales, P. & Santodomingo, J. (1993). Severe burn injuries and PTSD. American Journal of Psychiatry 150, 1276.Google Scholar
Perry, S., Difede, J., Musngi, G., Frances, A.J. & Jacobsberg, L.(1992). Predictors of post-traumatic stress disorder after burn injury. American Journal of Psychiatry 149, 931–935.Google Scholar
Pitman, R.K., Altman, B. & Macklin, M.L. (1989). Prevalence of post-traumatic stress disorder in wounded Vietnam veterans. American Journal of Psychiatry 146, 667–669.Google Scholar
Ramsay, R., Gorst-Unsworth, C. & Turner, S. (1993). Psychiatric morbidity in survivors of organised state violence including torture. A retrospective series. British Journal of Psychiatry 162, 55–59.Google Scholar
Raphael, B. (1986). When Disaster Strikes. Hutchinson: London.Google Scholar
Realmuto, G.M., Masten, A., Carole, L.F., Hubbard, J., Groteschulen, A. & Chhun, B. (1992). Adolescent survivors of massive childhood trauma in Cambodia: life events and current symptoms. Journal of Traumatic Stress 5, 589–599.CrossRefGoogle Scholar
Resnick, H.S., Kilpatrick, D.G., Best, C.L. & Kramer, T.L. (1992). Vulnerabilify and stress factors in development of post-traumatic stress disorder. Journal of Nervous and Mental Disease 180, 424–430.Google Scholar
Riggs, D.A., Dancu, C.V., Gershuny, B.S., Greenberg, D. & Foa, E.B. (1992). Anger and post-traumatic stress disorder in female crime victims. Journal of Traumatic Stress 5, 613–624.Google Scholar
Roberts, W.R., Penk, W.E., Gearing, M.L., Robinowitz, R., Dolan, M.P. & Patterson, E.T. (1982). Interpersonal problems of Vietnam combat veterans with symptoms of post-traumatic stress disorder. Journal of Traumatic Stress 91, 444–450.Google Scholar
Robins, L.N. & Regier, D.A. (1991). Psychiatric Disorders in America. The Free Press: New York.Google Scholar
Roca, R.P., Spence, R.J. & Munster, A.M. (1992). Post-traumatic adaptation and distress among adult burn survivors. American Journal of Psychiatry 149, 1234–1238.Google Scholar
Rothbaum, B.O., Foa, E.B., Riggs, D.S., Murdock, T. & Walsh, W. (1992). A prospective exmination of post-traumatic stress disorder in rape victims. Journal of Traumatic Stress 5, 455–476.Google Scholar
Rubonis, A.V. & Bickman, L. (1991). Psychological impairment in the wake of disaster: the disaster-psychopathology relationship. Psychological Bullettin 109, 384–399.CrossRefGoogle ScholarPubMed
Rudd, M.D., Dahm, P.F. & Rajab, M.H. (1993). Diagnostic comorbidity in persons with suicidal ideation and behavior. American Journal of Psychiatry 150, 928–934.Google ScholarPubMed
Schnurr, P.P., Friedman, M.J. & Rosenberg, S.D. (1993). Premilitary MMPI scores as predictors of combat-related PTSD symptoms. American Journal of Psychiatry 150, 479–483.Google Scholar
Schottenfeld, R.S. & Cullen, M.R. (1985). Occupation induced post-traumatic stress disorders. American Journal of Psychiatry 142, 198–202.Google Scholar
Schwarz, E.D. & Kowalski, J.M. (1991). Malignant memories: PTSD in children and adults after a school shooting. Journal of the Academy of Child and Adolescent Psychiatry 30, 936–944.CrossRefGoogle ScholarPubMed
Shalev, A.Y. (1992). Post-traumatic stress disorder among injured survivors of a terrorist attack. Predictive value of early intrusion and avoidance symptoms. Journal of Nervous and Mental Disease 180, 505–509.Google Scholar
Sherwood, R.J., Funari, D.J. & Piekarski, A.M. (1990). Adapted character styles of Vietnam veterans with post-traumatic stress disorder. Psychological Report 66, 623–631.Google Scholar
Shore, J.H., Vollmer, W.M. & Tatum, E.L. (1989). Community patterns of post-traumatic stress disorders. Journal of Nervous and Mental Disease 177, 681–685.Google Scholar
Silverman, J.J., Hart, R.P., Garrettson, L.K., Stockman, S.J., Hamer, R.M., Schulz, S.C. & Narasimhachari, N. (1985). Posttraumatic stress disorder from pentaborane intoxication. Neuropsychiatric evaluation and short-term follow-up. Journal of the American Medical Association 254, 2603–2608.Google Scholar
Skre, I., Onstad, S., Torgensen, S., Lygren, S. & Kringlen, E. (1993). A twin study of DSM-III-R anxiety disorders. Ada Psychiatrica Scandinavica 88, 85–92.Google Scholar
Sloan, P. (1988). Post-traumatic stress in survivors of an airplane crash-landing: a clinical and exploratory study. Journal of Traumatic Stress 1, 211–229.Google Scholar
Smith, E.M. & North, C. (1993). Post-traumatic stress disorder in natural disaster and technological accident. In International Handbook of Traumatic Stress Syndromes (ed. Wilson, J. and Raphael, B.). Plenum Press: New York.Google Scholar
Smith, E.M., Robins, L.N., Przybeck, T.R., Goldring, E. & Solomon, S.D. (1986). Psychosocial consequences of a disaster. In Disaster Stress Studies: New Methods and Findings (ed. Shore, J.H.), pp. 50–76. APA: Washington, DC.Google Scholar
Smith, E.M., North, C.S., McCool, R.E. & Shea, J.M. (1990). Acute postdisaster psychiatric disorders: identification of persons at risk. American Journal of Psychiatry 147, 202–206.Google Scholar
Snow, B.R., Mager-Stellman, J., Stellman, S.D. & Sommer, J.F. Jr (1988). Post-traumatic stress disorder among American legionnaires in relation to combat experience in Vietnam: associated and contributing factors. Environmental Research 47, 175–192.Google Scholar
D., Solomon S. & Canino, G.J. (1990). Appropriateness of DSM-III-R criteria for post-traumatic stress disorder. Comprehensive Psychiatry 31, 227–237.Google Scholar
Solomon, Z. & Mikulincer, M. (1987). Post-traumatic stress disorder among frontline soldiers with combat stress reactions: the 1982 Israeli experience. American Journal of Psychiatry 144, 448–454.Google Scholar
Solomon, Z., Laor, N., Weiler, D., Muller, U.F., Hadar, O., Waysman, M., Koslowsky, M., Yakar, M.B. & Bleich, A. (1993). The psychological impact of the Gulf War: a study of acute stress in Israeli evacuees. Archives of General Psychiatry 50, 320–321.Google Scholar
Southwick, S.M., Morgan, A., Nagy, L.M., Bremner, D., Nicolaou, A.L., Johnson, D.R., Rosenheck, R. & Charney, D.S. (1993). Trauma-related symptoms in veterans of Operation Desert Storm: a preliminary report. American Journal of Psychiatry 150, 1524–1528.Google Scholar
Speed, N., Engdahl, B., Schwartz, J. & Eberly, R. (1989). Post-traumatic stress disorder as a consequence of the POW experience. Journal of Nervous and Mental Disease 177, 147–153.Google Scholar
Steiner, Craine L., Henson, C.E., Colliver, J.A. & MacLean, D.G. (1988). Prevalence of a history of sexual abuse among female psychiatric patients in a state hospital system. Hospital and Community Psychiatry 39, 300–304.Google Scholar
Steinglass, P. & Gerrity, E. (1990). Natural disasters and post-traumatic stress disorder: short-term versus long-term recovery rates in two disaster-affected communities. Journal of Applied and Social Psychology 20, 1746–1765.CrossRefGoogle Scholar
Streimer, J.H., Cosstick, J. & Tennant, C. (1985). The psychosocial adjustment of Australian Vietnam veterans. American Journal of Psychiatry 142, 616–618.Google Scholar
Stretch, R.H. (1990). PTSD and the Canadian Vietnam veteran. Journal of Traumatic Stress 3, 239–253.Google Scholar
Stretch, R.H. (1991). Psychosocial readjustment of Canadian Vietnam veterans. Journal of Consulting and Clinical Psychology 59, 188–189.Google Scholar
Stretch, R.H., Vail, J.D. & Maloney, J.P. (1985). Post-traumatic stress disorder among army nurse corps Vietnam veterans. Journal of Consulting and Clinical Psychology 53, 704–708.Google Scholar
Summerfield, D. & Toser, L. (1991). ’Low intensity’ war and mental trauma in Nicaragua: a study in a rural community. Medicine and War 7, 84–99Google Scholar
Sutker, P.B., Allain, A.N. Jr & Winstead, D.K. (1993a). Psychopathology and psychiatric diagnoses of World War II Pacific theater prisoner of war survivors and combat veterans. American Journal of Psychiatry 150, 240–245.Google Scholar
Sutker, P.B., Uddo, M., Brailey, K. & Allain, A.N. (1993b). Warzone trauma and stress-related symptoms in operation Desert Shield/Storm (ODS) returnees. Journal of Social Issues 49, 33–49.Google Scholar
Toole, M.J. & Waldman, R.J. (1993). Prevention of excess mortality in refugee and displaced populations in developing countries. Journal of the American Medical Association 263, 3296–3302.CrossRefGoogle Scholar
van Dijk, J.J.M. & Mayhew, P. (1993). Criminal victimisation in the industrialised world: key findings of the 1989 and 1992 international crime surveys. In Understanding Crime: Experiences of Crime and Crime Control (ed. Frate, A. Alvazzi del, Zvekic, U. and Dijk, J.J.M. van), pp. 1–50. UNICRI: Roma.Google Scholar
Warshaw, M.G., Fierman, E., Pratt, L., Hunt, M., Yonkers, K.A., Massion, A.O. & Keller, M.B. (1993). Quality of life and dissociation in anxiety disorder patients with histories of trauma or PTSD. American Journal of Psychiatry 150, 1512–1516.Google Scholar
Weisaeth, L. (1989). A study of behavioural responses to an industrial disaster. Acta Psychiatrica Scandinavica, Supplementum 80, 13–24.Google Scholar
Weisaeth, L. (1993). Torture of a Norwegian ship's crew: stress reactions, coping and psychiatric aftermath. In International Handbook of Traumatic Stress Syndromes (ed. Wilson, J. and Raphael, B.), pp. 743–750. Plenum Press: New York.Google Scholar
World Health Organization (1992a). Decima Revisione delta Classificazione Internazionale delle Sindromi e dei Disturbi Psichici e Comportamentali. Descrizioni Cliniche e Direttive Diagnostiche. Edizione italiana a cura di Kemali, D., Maj, M., Catapano, F., Lobrace, S. & Magliano, L.. Milano: Masson.Google Scholar
World Health Organization (1992b). Psychosocial Consequences of Disasters. Prevention and Management. WHO: Geneva.Google Scholar
Wolfe, J., Brown, P.J. & Kelley, J.M. (1993). Reassessing war stress: exposure and the Persian Gulf war. Journal of Social Issues 49, 15–31.Google Scholar
Zwi, A.B. (1991). Militarism, militarization, health and the third world. Medicine and War 7, 262–268.Google Scholar