Table 2.
Author- Year |
Time Frame |
Sample Size & Population |
Criteria & Methods |
Inciting Events |
Diagnostic measure |
Comorbidities & Risk Factors |
Major Findings |
---|---|---|---|---|---|---|---|
Boyd-Ball 2006[17] |
1997 - 2000 |
423 adolescents and young adults from a Southwest tribe |
Enrolled tribal members in SUPERPF P dataset, age 15-24 years. Survey; descriptive statistics and logistic regression |
Parental alcohol use |
DSM-IV |
Risk factor:
Parental alcohol use |
Severe trauma increased odds of alcohol use disorders (direction of association unclear). Severe traumatic events correlated with parental alcohol use. Severe IPV may have stronger association with alcohol use disorders than severe non-interpersonal trauma, witnessed trauma, or traumatic news. |
Brinker 2007[18] |
255 male AI/AN and Hispanic veterans with lifetime PTSD in Southwest and North Central region |
Community -based sample Descriptive statistics and logistic regression |
Combat experience |
PCL | Veterans with combat-related PTSD had more severe symptoms, were less likely to have remitted in the previous year, and were less likely to have sought mental health treatment after military duty. |
||
Csordas 2008[19] |
84 Navajo adults in the Southwest |
Past patients of Navajo Healing Project (10- year ethnographic study of therapeutic process) Ethnography and descriptive statistical analysis of interview data |
SCID | Of 78 patients meeting DSM- IV SCID criteria, 7.7% had subthreshold lifetime MD, 29.5% had lifetime MD, 11.5% had subthreshold lifetime PTSD, 23.1% had lifetime PTSD, 5.1% had current PTSD, 5.1% had current other anxiety disorder, 20.5% had lifetime other anxiety disorder, 34.6% had lifetime alcohol use dependence, 9% had lifetime alcohol use abuse. Lifetime PTSD was 25% for participants affiliated with Native American Church, 19.3% for Traditional, and 25.9% for Christian. 23.1% were free from any lifetime psychiatric stress. 16.1% of men and 23.4% of women reported full PTSD. Lifetime PTSD was 23.5% among married, 9.1% among widowed/separated/divorced (but 45.5% of this group reported subthreshold PTSD), and 31.3% among single. |
|||
Dickerson 2000[20] |
1999 - 2001 |
480 AI/AN male veterans from the North Central region of U.S. |
AIAN male veterans in a community- based sample Cross- tabulations and odds ratios, logistic regression |
Quick- Diagnostic Interview Schedule to determine DSM- III-R diagnosis |
Comorbidity:
Lifetime nicotine dependence Risk factor: Lifetime nicotine dependence |
Lifetime prevalence of PTSD was 11.9% The highest prevalence of lifetime nicotine dependence was found in those with a lifetime history of affective disorders (61.9%), followed by PTSD (52.6%) Odds of lifetime PTSD were higher among those with lifetime nicotine dependence than among those without. |
|
Dillard 2007[21] |
1993 - 1994 |
591 AI male veterans in the Southwest |
AIAN male Vietnam veterans identified through tribal rolls (AIVVP dataset) Retrospective analysis of survey data using descriptive statistics and linear regression |
Mississippi Scale for Combat- Related PTSD and DSM-III-R |
CD not associated with increased odds of high war zone stress. CD associated with higher combat-related PTSD symptoms among veterans independent of war zone stress level. |
||
Ducci 2008[22] |
291 AI women in the Southwest |
Recruited from a Southwest tribe, age ≥ 21. Descriptive statistics and frequencies . |
DSM-III-R |
Risk factor: Low activity allele in the MAOA locus; CSA |
Women who had experienced CSA and were homozygous for the low activity allele in the MAOA locus had higher prevalence of alcoholism and ASPD, and more ASPD symptoms, than abused women homozygous for the high activity allele. No relationship between alcoholism and ASPD and MAOA-LRP genotype in non- abused women. |
||
Duran 2004[23] |
1999 | 234 AI/AN women, Albuquerque, NM |
Between 18 and 45 years, received medical care from IHS facilities Statistical analysis of interview data |
CIDI |
Risk factor: Child abuse and neglect |
76.5% reported some type of CAN; more than 40% reported severe CAN. Severity of CAN was associated with lifetime diagnosis of psychiatric disorders. Severe CAN was most strongly associated with lifetime PTSD. Lifetime PTSD prevalence was 3.9. |
|
Duran 2009[24] |
1999 | 234 AI women, Albuquerque, NM |
Between 18 and 45 years, received medical care from IHS facilities; fluent in English Statistical analysis of interview data |
CIDI |
Comorbidities:
Severe IPV, high debt Risk factors: Severe IPV, high debt, family history of alcohol use |
Unadjusted prevalence ratios for severe physical and sexual abuse were significant for anxiety, PTSD, mood, and any mental disorder. Women with severe IPV were five times more likely to have PTSD than women without IPV . |
|
Evans- Campbell 2006[25] |
2000 - 2003 |
112 adult AI/AN women, New York City |
Enrolled tribal member living in NYC from an AI/AN community center, then random sample. Survey, descriptive statistics and logistic regression |
IPV |
Comorbidities:
Depression, dysphoria, risky sexual behaviors Risk factors: Interpersonal violence |
Over 65% experienced IPV (28% childhood physical abuse, 48% rape, 40% domestic violence, 40% multiple victimization). History of IPV associated with depression, dysphoria, help- seeking, and high HIV risk sexual behaviors. |
|
Gnanade sikan 2005[26] |
1997 - 1999 |
349 young AI adults in the Northern Plains |
Ages 15- 24, members of a Northern Plains tribe, previous participation in a community- based study Logistic regression |
CIDI |
Risk factors: Sexual trauma; experiencing 6 or more traumas |
42 (12% of those who experienced a traumatic event) met criteria for lifetime PTSD. |
|
Kramer 2009[27] |
2002 - 2003 |
Nationwide sample: 4338 female AI/AN veterans; 1518 female AI/AN nonveterans |
Women among all IHS beneficiaries who were veterans or used VHA for health care Secondary data analysis; descriptive |
Combat experience |
Medical needs of female AI/AN veterans were similar to other veterans. Most frequent diagnoses for outpatient were similar to general population of female vets: hypertension, depression, and PTSD. 82 of 804 veteran dual users receiving attention for PTSD; 26 of 1518 nonveteran dual users. |
||
Laudenslager 2009[28] |
66 AI/AN men and women in the Southwest |
Drawn from previous large-scale study Descriptive statistics |
CIDI |
Comorbidity:
Higher cortisol levels |
Women with lifetime PTSD had sig higher mean cortisol levels throughout the day than women without PTSD. No significant association in men. No influence from alcohol use. |
||
Manson 1996[29] |
One 45- year-old AI man in Arizona |
Case study | Combat experience, bereavement after death of father |
Medical diagnosis |
Comorbidity: Alcohol dependence Risk factors: Perhaps family history of alcoholism, combat- related trauma, alcohol dependence, history of childhood physical abuse, and bereavement. |
In interviewee’s view, his combat experience in Vietnam and his failure to participate in the cultural grieving process after his father’s death upset his physical, mental, emotional, and spiritual health. Identifying with his culture and participating in tribal ceremonies and Native veteran support group and Native American Church improved his outcome. |
|
Robin 1997[30] |
1991 - 1995 |
247 AI/AN adults |
Age ≥ 21 years, eligible for enrollment in a Southwestern tribe Descriptive statistics and logistic regression |
Physical assault, combat experience, multiple traumatic events |
SCID and DSM-III-R |
Risk factors:
For lifetime PTSD, women: physical assault; men: history of combat, more than 10 traumatic events |
Prevalence of lifetime PTSD was 21.9% 81.4% had experienced at least one traumatic event. Prevalence of lifetime PTSD and exposure to traumatic events was higher than in general U.S. population. |
Robin 1998[31] |
104 members of a Southwestern tribe |
Age ≥ 21 years, eligible for enrollment in a Southwestern tribe Bivariate analysis; logistic regression |
For women: forced sex |
DSM-III-R |
Risk
factors: IPV for both genders and forced sex for women |
Men and women reported high prevalence of lifetime (91%) and recent (31%) IPV. For women, forced sex was only significant predictor of lifetime affective disorders and lifetime PTSD. |
|
Saylors 2006[32] |
1999 -2002 |
283 AI/AN women in Oakland and San Francisco, CA |
Native women receiving residential and outpatient services for substance abuse and mental illness Descriptive analysis of structured interviews in three stages over one year |
Possibly CSA |
Comorbidities:
Perhaps substance abuse; other mental health disorders Risk factors: Perhaps CSA; physical abuse, sexual abuse, forced sex, alcohol abuse |
89% had been emotionally abused in their lifetime. 84% had been physically abused in lifetime. 67% had been sexually abused in their lifetime. 39% had experienced forced sex. 96.7% who were sexually abused were AIso physically abused. 78.4% who were physically abused reported being AIso sexually abused. 94.7% of those who were physically abused were AIso emotionally abused. 95.8% of those who were sexually abused were AIso emotionally abused. 55.6% reported CSA. 75% reported adult violence. 84% of those who were sexually abused sought mental health services; 56% sought substance abuse services. Any type of abuse, 40% had dual mental health and substance abuse diagnosis. 88.3% used alcohol to intoxication during their lifetime. 78% said Native identity was important to them; 100% at 12-month follow-up. |
|
Sawchuck 2005[33] |
1414 AI adults in the Northern Plains |
Northern Plains AIs living on or within 20 miles of their reservation; ages 18-57 years Descriptive statistics and logistic regression |
Comorbidity:
CVD |
Prevalence of lifetime PTSD was 15%. CVD was more commonly reported by those with PTSD than those without (12% v. 5%). PTSD was significantly associated with CVD after controlling for traditional CVD risk factors and MD. |
|||
Shore 2004[34] |
One AI man in the Southwest Case study |
Combat experience |
Medical diagnosis |
Comorbidities:
PTSD, Alcohol dependence |
Drinking, contradictory views about PTSD, stigma related to PTSD, and limited access to resources impeded treatment. Telehealth clinic helped facilitate treatment, course, and outcome. |
||
Shore 2009[35] |
1993 - 1994 |
305 male Vietnam veterans from a Northern Plains tribe |
Population- based sample, then clinical interview of subsample from larger survey Chi-square tests; presentation of qualitative materiAIs |
Combat experience |
Mississippi Scale for Combat- Related PTSD |
Comorbiditiy: Nightmares Risk factors: Combat experience |
Combat-related PTSD group had a mean PTSD symptom count of 12.5, higher than the mean symptom count for the non-combat related PTSD group (9.3), and higher than the trauma/no PTSD group. 100% of those who reported experiencing violence reported experiencing nightmares. |
Villanueva 2003[36] |
1994 - 1996 |
Nearly 70% of Hopi Vietnam veterans living on the Hopi reservation during study period. |
Vietnam veteran living on Hopi reservation during study period Ethnography and survey |
Mississippi Scale for Combat- Related PTSD; Minnesot a Multiphasic Personality Inventory -PK Scale; SCID |
Hopi veterans had PTSD prevalence nearly triple any other tribal or ethnic group. Hopi men who had been initiated into the highest order of Hopi secret religious societies had the lowest scores on any measure of PTSD. Suggests that variables such as levels of spirituality may be more important when predicting PTSD than race or ethnicity. |
||
Westermeyer 2009[37] |
1991 - 2001 |
Male and female AI/AN veterans in Albuquerque, NM, and Minneapolis, MN |
AI veterans in Albuquerque and Minneapolis using 1990 census. Chi-squaretests and binary logistic regression. |
Combat experience |
PCL; DSM-III-R |
Comorbidities:
Tobacco dependence, antisocial personality disorders, pathological gambling. Risk factor: Male gender |
Women were younger, had more education, than men. Men were more likely to be in combat than women, but no difference for lifetime exposure to criterion A trauma. No difference between genders in alcohol use. Men more likely to use drugs (i.e., cannabis). No gender differences for comorbidities. Men had more PTSD symptoms than women. |