Posttraumatic stress disorder and symptoms among American Indians and Alaska Natives: a review of the literature
American Indians and Alaska Natives (AI/ANs) experience high rates of trauma and posttraumatic stress disorder (PTSD). We reviewed existing literature to address three interrelated questions: (1) What is the prevalence of PTSD and PTSD symptoms among AI/ANs? (2) What are the inciting events, risk factors, and co-morbidities in AI/ANs, and do they differ from those in the general U.S. population? (3) Are studies available to inform clinicians about the course and treatment of PTSD in this population?
We searched the PubMed and Web of Science databases and a database on AI/AN health, capturing an initial sample of 77 original English-language articles published 1992–2010. After applying exclusion criteria, we retained 37 articles on prevalence of PTSD and related symptoms among AI/AN adults. We abstracted key information and organized it in tabular format.
AI/ANs experience a substantially greater burden of PTSD and related symptoms than U.S. Whites. Combat experience and interpersonal violence were consistently cited as leading causes of PTSD and related symptoms. PTSD was associated with bodily pain, lung disorders, general health problems, substance abuse, and pathological gambling. In general, inciting events, risk factors, and co-morbidities appear similar to those in the general U.S. population.
Substantial research indicates a strikingly high incidence of PTSD in AI/AN populations. However, inciting events, risk factors, and co-morbidities in AI/ANs, and how they may differ from those in the general population, are poorly understood. Very few studies are available on the clinical course and treatment of PTSD in this vulnerable population.
KeywordsPosttraumatic stress disorder Trauma American Indians Alaska Natives
This work was supported by grant number T32MH082709-01A2 from the National Institute for Mental Health, which supports the Center for Healthcare Improvement for Addictions, Mental Illness and Medically Vulnerable Populations (CHAMMP; P. Roy-Byrne, Principal Investigator), grant number UL1RR025014 from the National Center for Research Resources, which supports the Institute for Translational Health Sciences (M. Disis, Principal Investigator), and grant number P60 MD000507 from the National Institute of Minority Health and Health Disparities (S.M. Manson, Principal Investigator).
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
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