Table 2.
Odds of DSM-IV CIDI-Diagnosed PTSD Associated With Randomly Selected TEs as a Function of TE Type and Prior Lifetime Exposure of the Same TE Type Among People Exposed to 1 or More Lifetime TEs Across All WMH Surveysa
| Traumatic Experience | Model 1b | Model 2 | Model 3 | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR (95% CI) | χ2 Value | df | P Value | OR (95% CI) | χ2 Value | df | P Value | OR (95% CI) | χ2 Value | df | P Value | ||
| 1. Exposure to organized violence | |||||||||||||
| Full set of ORsc | NA | 34.7 | 4 | <.001 | NA | 37.5 | 4 | <.001 | NA | 37.0 | 3 | <.001 | |
| Significance of differencesd | NA | 34.4 | 3 | <.001 | NA | 35.1 | 3 | <.001 | NA | 34.9 | 2 | <.001 | |
| Civilian in war zone | 0.2 (0.1–0.6) | 8.7 | 1 | .003 | 0.3 (0.1–0.7) | 6.6 | 1 | .01 | 0.3 (0.1–0.8) | 5.9 | 1 | .02 | |
| Civilian in region of terror | 0.3 (0.1–0.6) | 8.8 | 1 | .003 | 0.3 (0.1–0.8) | 6.1 | 1 | .01 | 0.3 (0.1–0.8) | 5.6 | 1 | .02 | |
| Refugee | 1.5 (0.6–3.6) | NA | NA | NA | 1.9 (0.8–4.5) | NA | NA | NA | NA | NA | NA | NA | |
| Kidnapped | 3.8 (2.0–7.1) | 17.5 | 1 | <.001 | 4.7 (2.5–8.8) | 24.1 | 1 | <.001 | 4.9 (2.6–9.3) | NA | NA | NA | |
| 2. Participation in organized violence | |||||||||||||
| Full set of ORsc | NA | 25.4 | 5 | <.001 | NA | 17.0 | 5 | .004 | NA | 9.0 | 2 | .01 | |
| Significance of differencesd | NA | 14.0 | 4 | .007 | NA | 14.4 | 4 | .006 | NA | 6.3 | 1 | .01 | |
| Witnessed death, dead body, or serious injury | 0.5 (0.4–0.8) | 11.4 | 1 | <.001 | 0.7 (0.4–0.9) | 5.0 | 1 | .03 | 0.7 (0.4–1.0) | 3.3 | 1 | .07 | |
| Unintentionally caused serious injury or death | 0.6 (0.2–1.5) | NA | NA | NA | 0.7 (0.3–1.9) | NA | NA | NA | NA | NA | NA | NA | |
| Combat experience | 0.7 (0.3–1.7) | NA | NA | NA | 0.9 (0.4–2.1) | NA | NA | NA | NA | NA | NA | NA | |
| Purposely injured, tortured, or killed someone | 2.2 (0.5–10.1) | NA | NA | NA | 2.8 (0.6–12.5) | NA | NA | NA | NA | NA | NA | NA | |
| Witnessed atrocities | 3.2 (0.8–12.8) | NA | NA | NA | 4.0 (1.0–16.3) | 3.9 | 1 | .05 | 4.2 (1.0–17.8) | 3.7 | 1 | .05 | |
| 3. Experience of physical violence | |||||||||||||
| Full set of ORsc | NA | 4.5 | 3 | .22 | 1.2 (0.8–1.7) | NA | NA | NA | NA | NA | NA | NA | |
| Significance of differencesd | NA | 4.4 | 2 | .11 | NA | NA | NA | NA | NA | NA | NA | ||
| Beaten up by someone else | 0.7 (0.4–1.2) | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| Witnessed physical fight at home | 0.9 (0.6–1.4) | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| Beaten up by caregiver | 1.5 (0.9–2.5) | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| 4. Experience of sexual violence | |||||||||||||
| Full set of ORsc | NA | 65.1 | 7 | <.001 | 2.7 (2.0–3.6) | 43.1 | 1 | <.001 | 2.7 (2.0–3.8) | 39.0 | 1 | <.001 | |
| Significance of differencesd | NA | 10.2 | 6 | .12 | NA | NA | NA | NA | NA | NA | NA | NA | |
| Raped | 3.8 (2.5–5.8) | 39.0 | 1 | <.001 | NA | NA | NA | NA | NA | NA | NA | NA | |
| Sexually assaulted | 2.4 (1.6–3.5) | 19.5 | 1 | <.001 | NA | NA | NA | NA | NA | NA | NA | NA | |
| Stalked | 2.0 (1.1–3.7) | 5.3 | 1 | .02 | NA | NA | NA | NA | NA | NA | NA | NA | |
| Beaten up by spouse or romantic partner | 1.9 (1.3–2.9) | 10.2 | 1 | .001 | NA | NA | NA | NA | NA | NA | NA | NA | |
| Traumatic event to loved one | 1.7 (0.9–3.1) | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| Some other event | 1.6 (1.1–2.4) | 5.9 | 1 | .02 | NA | NA | NA | NA | NA | NA | NA | NA | |
| Private evente | 2.1 (1.5–2.9) | 16.7 | 1 | <.001 | NA | NA | NA | NA | NA | NA | NA | NA | |
| 5. Accidents and/or injuries | |||||||||||||
| Full set of ORsc | NA | 62.2 | 6 | <.001 | NA | 54.2 | 6 | <.001 | NA | NA | NA | NA | |
| Significance of differencesd | NA | 46.9 | 5 | <.001 | NA | 49.1 | 5 | <.001 | NA | NA | NA | NA | |
| Natural disaster | 0.1 (0.0–0.1) | 48.1 | 1 | <.001 | 0.1 (0.0–0.2) | 42.9 | 1 | <.001 | 0.1 (0.0–0.2) | 41.5 | 1 | <.001 | |
| Toxic chemical exposure | 0.6 (0.2–1.6) | NA | NA | NA | 0.7 (0.3–2.0) | NA | NA | NA | NA | NA | NA | NA | |
| Automobile crash | 0.6 (0.4–0.9) | 6.0 | 1 | .01 | 0.7 (0.5–1.1) | NA | NA | NA | NA | NA | NA | NA | |
| Life-threatening illness | 0.6 (0.3–0.9) | 5.5 | 1 | .02 | 0.7 (0.4–1.1) | NA | NA | NA | NA | NA | NA | NA | |
| Child with serious illness | 1.1 (0.8–1.6) | NA | NA | NA | 1.4 (1.0–2.1) | NA | NA | NA | NA | NA | NA | NA | |
| Other life-threatening accident | 1.7 (0.6–4.6) | NA | NA | NA | 2.1 (0.8–5.9) | NA | NA | NA | NA | NA | NA | NA | |
| 6. Other | |||||||||||||
| Full set of ORsc | NA | 7.7 | 3 | .05 | NA | 7.1 | 3 | .07 | NA | NA | NA | NA | |
| Significance of differencesd | NA | 6.9 | 2 | .03 | NA | 6.7 | 2 | .04 | NA | NA | NA | NA | |
| Mugged or threatened with a weapon | 0.6 (0.4–0.9) | 5.5 | 1 | .02 | 0.7 (0.5–1.2) | NA | NA | NA | NA | NA | NA | NA | |
| Man-made disaster | 0.6 (0.2–1.8) | NA | NA | NA | 0.8 (0.3–2.2) | NA | NA | NA | NA | NA | NA | NA | |
| Unexpected death of loved one | 1.2 (0.8–1.6) | NA | NA | NA | 1.4 (1.0–2.0) | 4.2 | 1 | .04 | 1.5 (1.0–2.0) | 4.4 | 1 | .04 | |
| 7. Prior lifetime exposure to the same TE type | |||||||||||||
| Full set of ORsc | NA | 14.2 | 5 | .01 | NA | 11.3 | 5 | .05 | NA | 10.8 | 21 | .005 | |
| Significance of differencesd | NA | 13.4 | 4 | .01 | NA | 10.4 | 4 | .03 | NA | 10.1 | NA | .001 | |
| Exposure to organized violencef | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| Participation in organized violence | 0.2 (0.1–0.8) | 5.1 | 1 | .02 | 0.2 (0.1–0.9) | 4.8 | 1 | .03 | 0.3 (0.1–0.9) | 4.5 | 1 | .03 | |
| Experience of physical violence | 3.2 (1.3–7.9) | 6.1 | 1 | .01 | 2.5 (1.0–6.4) | 3.9 | 1 | .05 | 3.2 (1.3–7.9) | 6.4 | 1 | .01 | |
| Experience of sexual violence | 0.8 (0.5–1.5) | NA | NA | NA | 0.9 (0.5–1.5) | NA | NA | NA | NA | NA | NA | NA | |
| Accidents and/or injuries | 0.4 (0.1–1.5) | NA | NA | NA | 0.5 (0.1–1.6) | NA | NA | NA | NA | NA | NA | NA | |
| Other | 0.7 (0.4–1.5) | NA | NA | NA | 0.8 (0.4–1.5) | NA | NA | NA | NA | NA | NA | NA | |
| 8. Design-adjusted AIC | 3326.2 | NA | NA | NA | 3283.4 | NA | NA | NA | 2943.3 | NA | NA | NA | |
Abbreviations: AIC, Akaike information criterion; CIDI, Composite International Diagnostic Interview; df, degree of freedom; NA, not applicable; OR, odds ratio; PTSD, posttraumatic stress disorder; TE, traumatic experience; WMH, World Mental Health.
Coefficients are based on multiple logistic regression equations with the 34 581 respondents who had a lifetime TE (exclusive of the 95 whose randomly selected TE was being a relief worker in a war zone) as the unit of analysis. All models control for respondent sex, age at interview, age at time of exposure to the TE, and 21 dummy variables to distinguish among the 22 surveys.
Given that all respondents experienced a TE, a model containing a separate unrestricted OR for each of the 28 TE types would be underidentified. The constraint we imposed to achieve identification was for the sum of the 28 logits to equal 0.0, which is equivalent to the product of the 28 ORs equaling 1.0. An OR significantly greater than 1.0 for a given TE type in this model consequently can be interpreted as showing that the odds of PTSD associated with that TE type are significantly greater than for the mean TE (noting that each TE is given equal weight when defining the average).
Assesses the significance of the full set of ORs for TEs in the group.
Assesses the significance of differences among these TEs within the group. Subsequent χ2 tests with 1 df are presented for the individually significant TEs in the group when the overall group-level χ2 value is significant.
Includes any TE that some individuals reported in response to a question at the very end of the TE section that asked if they ever had some other very upsetting experience they did not tell us about already (including in response to a prior open-ended question about any other TE) because they were too embarrassed or upset to talk about it. Before they answered, respondents were told that, if they reported such a TE, we would not ask them anything about what the TE was but only about their age when the TE happened.
No PTSD cases for those who had exposure to organized violence as their random event and experienced exposure to organized violence in the past were reported.