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Global prevalence of stress and trauma and related disorders 

Theme leader: Carolina Salgado
Aarde G-stress_edited.png

Approximately 70% of the world’s population have been exposed to a traumatic life event, and the resulting mental health problems represent a major challenge to public mental health services, globally.

Under this theme we look at the prevalence of extreme stressors and traumatic events around the word and its potential consequences.

G-Stress

A global assessment of the ICD-11 stress-related disorders

Project group

See Core collaborators and Collaborators below.

This project brings together traumatic stress experts from around the world including members of ISTSS, ESTSS, and DeGPT. Four of the collaborators are also part of the other Global Collaboration projects who such as the development of the Global Psychotrauma Screen (GPS), the e-pamphlets for adults who have experienced childhood trauma (Internet information on Childhood Abuse and Neglect ((iCAN)) the the CARTS project (ongoing). 

Core Collaborators

  • Prof. Menachem Ben-Ezra, School of Social Work, Ariel University, Ariel, Israel.

  • Prof. Jon Bisson, School of Medicine, Cardiff University, Cardiff, UK.

  • Prof. Chris Brewin, Clinical, Educational, and Health Psychology, University College London, London, UK.

  • Prof. Marylene Cloitre, National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, United States of America.

  • Prof. Thanos Karatzias, Edinburgh Napier University, School of Health & Social Care, Edinburgh, UK.

  • Prof. Brigitte Lueger-Schuster, Department of Applied Psychology, University of Vienna, Vienna, Austria.

  • Prof. Andreas Maercker, Department of Psychology, Division of Psychopathology, University of Zurich, Zurich, Switzerland.

  • Prof. Miranda Olff, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, and ARQ National Psychotrauma Center, Diemen, Netherlands.

  • Dr Neil Roberts, Cardiff & Vale University Health Board, Cardiff, UK and School of Medicine, Cardiff University, Cardiff, UK.

  • Prof. Mark Shevlin, School of Psychology, Ulster University, Derry, Northern Ireland.

  • Dr Frédérique Vallières Trinity Centre for Global Health, University of Dublin, Trinity College, Dublin, Republic of Ireland.

Collaborators

  • Ms. Kristina Bondjers, Uppsala University, Uppsala, Sweden.

  • Prof. Wai Tong Chien, The Chinese University of Hong Kong, Hong Kong.

  • Prof. Amy Chow, University of Hong Kong, Hong Kong.

  • Ms. Carmen Fernández-Fillol, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Spain.

  • Andres Fresno, University of Talca, Chile.

  • Ms. Marieke van Gelderen, Arq Psychotrauma Expert Group, Centrum ’45, Netherlands.

  • Dr. Ohad Gilbar, Bar-Ilan University, Israel.

  • Dr. Sachiko Inoue, Okayama Prefectural University, Japan.

  • Dr. Evaldas Kazlauskas, Vilnius University, Lithuania.

  • Dr. Matthias Knefel, University of Vienna, Austria.

  • Dr. Grace W.K. Ho, The Hong Kong Polytechnic University, Hong Kong.

  • Dr. Eoin McElroy, University College London, UK.

  • Ms. Grainne McGinty, Maynooth University, Kildare, Ireland.

  • Carolina Salgado, University of Talca, Chile.

  • Prof. Daja Somarasundaram, University of Jaffna, Sri Lanka.

  • Prof. Jiangping Wang, Beijing Normal University, Beijing, China.

  • Dr. Pei-Jung (Annie) Yang, National Chengchi University, Taiwan.

Background

Approximately 70% of the world’s population have been exposed to a traumatic life event (Benjet et al., 2016, Kessler et al., 2017), and the resulting mental health problems represent a major challenge to public mental health services, globally (Sara & Lappin, 2017). In 2018, the World Health Organization (WHO) released the 11th version of the International Classification of Diseases (ICD-11), the primary diagnostic manual used by health professionals worldwide (First, Reed, Hyman, & Saxena, 2015). All United Nations member states are committed to using the ICD-11, and relevant to psychotraumatologists, ICD-11 provides novel descriptions of stress-related psychopathology compared to the ICD-10 and the DSM-5 (American Psychiatric Association, 2013).

Under the parent category of ‘Disorders Specifically Associated with Stress’, ICD-11 defines a number of stress-related disorders including ‘Posttraumatic Stress Disorder’ (PTSD) (PB40), ‘Complex PTSD’ (CPTSD) (PB41), ‘Prolonged Grief Disorder’ (PB42), and ‘Adjustment Disorder’ (PB43). The guiding principles underlying the development on these disorders were that they should (a) maximize clinical utility by including a small number of core symptoms and (b) be internationally applicable (Maercker et al., 2013). The World Mental Health Survey consortium have provided information about the prevalence of traumatic life events, and PTSD, internationally (Benjet et al., 2016; Karam et al., 2014). While valuable, these studies utilized the now outdated DSM-IV description of PTSD.

 

Aims

As ICD-11 represents the primary diagnostic manual used worldwide, and includes a new and distinct model of stress-related psychopathology, it is imperative for psychotraumatology research and practice to determine the global prevalence rates of these disorders.

Methods and Output

Members of the G-Stress Project have begun to assess the current prevalence rates of the ICD-11 stress-related disorders using nationally representative samples in countries like Israel (Hyland et al., under review; Kilkelly et al., 2019), Germany (Maercker et al., 2018), United Kingdom (Maercker et al., 2018; Cloitre et al., 2018) and United States (Cloitre et al., in press). It is clear that substantially more data is needed from nations all around the world to better understand how common these disorders are. In this project, we invite members of the ISTSS’s Global Collaboration to contribute to the ongoing work that aims to ascertain the prevalence of the ICD-11 stress-related disorders around the world. By obtaining information about the prevalence rates of the ICD-11 stress-related disorder at a global level, the ISTSS’s Global Collaboration will be able to provide the scientific community with vital information about the frequency and distribution of stress- and trauma-related events, and stress-related disorders, globally. This would allow for more effective and efficient resource planning among global health professionals. 

 

Trauma and PTSD in Dutch general population and in students

Project group

Chris Hoeboer, Joris Haagen, Birit Broekman, Federica Nava, Miranda Olff

Background and Aims

As part of G-Stress, which is focusing the global prevalence of ICD-11 related disorders, this study focuses on the assessment of trauma and trauma related disorders in the Netherlands, with a further focus on sex/gender aspects as well as treatment needs and barriers. 

We will investigate the following research questions:

1) What is the current prevalence rate of potentially traumatic events, PTSD and other trauma-related disorders in in the Netherlands in a representative sample of the general population as well as in a representative sample of students.

Sex/Gender focus: Are there differences in the manifestation of trauma-related symptoms related to sex and gender? Based on previous research, we expect men to have a higher prevalence of exposure to accidents and women to have a higher prevalence of exposure to sexual violence. We also women to have a higher PTSD, Complex PTSD, anxiety and depression prevalence but lower substance use disorder prevalence compared to men.

2) What is the current treatment gap and what are the treatment needs? What are barriers for seeking professional help and how does this relate to sex/gender?

Based on previous reports, we expect there to be a treatment gap and we expect that respondents might experience difficulties with accessing professional help after traumatic events during their study.

We expect male respondents to experience a larger treatment gap compared to female respondents

3) Which characteristics are related to treatment needs and the treatment gap? And how do these characteristics interact?

We expect that education level might be related to the treatment gap (with secondary vocational education be more at risk compared to applied higher education or University) as well as a larger treatment gap for types of trauma where stigma plays a role (i.e., sexual violence). We also expect that comorbidity/complexity of the complaints (e.g. complex PTSD or dissociative symptoms) to be related to less utilization of trauma-focused treatment.

 

Method 

Cross-sectional measurement of participants in the LISS panel followed by one interview for those who agree to this.

Self-report measures:

- Demographics: e.g., gender and sexual preference

- Traumatic events, including interpersonal events specifically during study period for students: LEC-5

- Traumatic events during study (for students)

- Trauma-related disorders: GPS

- DSM-5 PTSD (current and lifetime):  PCL-5

- ICD-11 PTSD and Complex PTSD: ITQ

- Depressive symptoms: PHQ-9

- Anxiety symptoms: GAD-7

- Substance abuse: ASSIST

- Quality of life EQ-5D-5L (1 item)

- Questions about past treatment and treatment needs

 

Interview:

- CAPS-5 for PTSD symptoms

- MINI for other trauma-related disorders

Sample size: Minimum 1425 in total

PreregistrationOSF Registries | Trauma and PTSD in Dutch general population

 

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