Traumatic events and their relative PTSD burden in Northern Ireland: A consideration of the impact of the 'Troubles'
Social Psychiatry and Psychiatric Epidemiology
Bamford Centre for Mental Health and Wellbeing, University of Ulster, Magee Campus, Northland Road, Londonderry BT48 7JL, United Kingdom; Bamford Centre for Mental Health and Wellbeing, University of Ulster, Londonderry, United Kingdom; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
Purpose: Over a 30-year period in its recent history, daily life in Northern Ireland (NI) was characterised by civil violence, colloquially termed as the 'Troubles'. The current report examines exposure to 29 traumatic event types and the associated conditional prevalence of post-traumatic stress disorder (PTSD) among the Northern Ireland population, with a focus on the impact of traumatic events that were characteristic of the NI 'Troubles'. Method: Results presented are based on analysis of data from the Northern Ireland Study of Health and Stress (NISHS). The NISHS is a representative epidemiological study of mental health among the NI adult population (N = 4,340) and part of the World Mental Health Survey Initiative. Results: Perpetration of violence, physical assault by a spouse or partner and private events were the event types associated with the highest conditional prevalence of PTSD. Despite this elevated risk, collectively these events accounted for just 16.8 % of the overall public burden of PTSD, given their low prevalence among the general population. Events that were characteristic of civil conflict, including unexpected death of a loved one, witnessing death or a dead body or someone seriously injured and being mugged or threatened with a weapon accounted for the highest proportion of the overall public health burden of PTSD (18.6, 9.4 and 7.8 %, respectively). These findings are a feature of the higher prevalence of these events among the general population coupled with their moderate to above average risk of PTSD. Conclusions: Despite the formal end to conflict in NI in 1999, a substantial proportion of the adult population continue to suffer the adverse mental health effects of chronic trauma exposure. Given rates of recovery of PTSD in the absence of evidence-based treatments, it is likely that the legacy of mental ill health associated with conflict, if not adequately addressed, will endure for many years. © 2013 Springer-Verlag Berlin Heidelberg.
adult; aged; article; cost of illness; female; human; male; mental health; mental stress; middle aged; posttraumatic stress disorder; prevalence; psychological aspect; statistics; United Kingdom; violence; Adult; Aged; Cost of Illness; Female; Humans; Male; Mental Health; Middle Aged; Northern Ireland; Prevalence; Stress Disorders, Post-Traumatic; Stress, Psychological; Violence
R01 MH070884, NIMH, National Institute of Mental Health; R01 MH093612-01, NIMH, National Institute of Mental Health; R03- TW006481, FIC, Fogarty International Center