Trauma exposure, incident psychiatric disorders, and disorder transitions in a longitudinal population representative sample
Section snippets
Background
Psychiatric disorders are highly comorbid, with 80% of individuals with a lifetime disorder meeting criteria for at least one additional disorder (Kessler et al., 1994). Comorbidity is associated strongly with disorder severity, with much of the population burden of lifetime psychiatric disorders concentrated among individuals who meet criteria for multiple disorders (Kessler et al., 1994, Kessler et al., 2005a). Identifying predictors of comorbidity and transitions across different disorders
Sample and procedures
Participants were 34,653 men and women from Waves 1 (2001–2002) and 2 (2004–2005) of the NESARC, a face-to-face survey of non-institutionalized adults living in households and group quarters (Hasin et al., 2007, Grant et al., 2008). The Wave 2 re-interview response rate among eligible Wave 1 participants was 86.7%, yielding a cumulative response rate of 70.2% (Grant et al., 2008). Young adults, Blacks, and Hispanics were oversampled and data were weighted in accordance with the 2000 census
Trauma exposure descriptives
More than one-quarter (25.89%) of the sample had a score of 33 (75th percentile) or higher on the child maltreatment measure, 7.21% reported interpersonal trauma, and 4.92% reported non-interpersonal trauma since the last interview.
Incident disorder prevalence
Table 1 displays the weighted prevalence of incident psychiatric disorder onsets at Wave 2 among individuals with and without a Wave 1 lifetime disorder, separately by sex. Chi-square tests for differences in incidence based on Wave 1 disorder presence also are
Discussion
This investigation extended research suggesting that heterotypic continuity is common by examining specific disorder transitions and predictors of these transitions in a large, nationally representative sample. Although the burden of psychiatric disorders is thought to be concentrated among a small subset of the population (Kessler et al., 2005b), findings indicated that incident psychiatric disorders were common in adulthood and cut across disorder categories. Individuals with a Wave 1
Disclosures
The authors have no conflicts of interest to report.
Acknowledgements
This research was funded by National Institutes of Health grants K01AA021511 (Keyes), LODA036213 (Walsh), T32DA031099 (PI: Hasin), and K01MH092526 (McLaughlin).
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