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      Which groups affected by Potentially Traumatic Events (PTEs) are most at risk for a lack of social support? A prospective population-based study on the 12-month prevalence of PTEs and risk factors for a lack of post-event social support

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          Abstract

          Objectives

          Little is known about the 12-month prevalence of potentially traumatic events (PTEs) and to what extent the type of PTE is a risk factor for post-event lack of social support. In addition, it is largely unknown if pre-event mental health problems and loneliness, and demographics are risk factors for a lack of support. Aim of the present prospective study is to fill these gaps in evidence-based knowledge.

          Methods

          A survey was conducted among a large random sample of the Dutch adult population (i.e. the longitudinal LISS panel) in March-April 2018, and linked with pre-event mental health and loneliness data from surveys conducted in 2016 (n = 5,879). We distinguished four forms of perceived social support: emotional and esteem support, and social recognition and general disapproval.

          Results

          Loss of a significant other and/or colleague (28%) was the most prevalent 12-month PTE. The 12-month prevalence of violence, accidents and/or, and theft-related events was 13%. Multivariate logistic regression analyses revealed no differences in lack of emotional and esteem support, or in lack of recognition across non-death PTEs and death-related PTEs. However, victims of threat and physical (sexual) violence more often faced disapproval than those affected by burglary and accidents. Results furthermore showed that pre-event mental health problems, pre-event loneliness and stress during the PTE were important independent predictors of forms of support and acknowledgment. Affected individuals with a non-Western background more often lacked support and acknowledgment.

          Conclusions

          Many adults are confronted with a PTE during a year. In general, pre-event factors and stress during the event are better predictors of a perceived lack of support and acknowledgment than type of event. Early screening programs should especially assess pre-event mental health and loneliness, besides levels of stress during the event, to identify affected people who are at risk for a lack of social support and acknowledgment.

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          Most cited references41

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          Posttraumatic stress disorder in the World Mental Health Surveys

          Background Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking. Methods Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics. Results The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed. Conclusions PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.
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            A test of the social support deterioration model in the context of natural disaster.

            This prospective longitudinal study examined stress-mediating potentials of 3 types of social support: social embeddedness, perceived support from nonkin, and perceived support from kin. As participants in a statewide panel study, 222 older adults were interviewed once before and twice after a severe flood. It was hypothesized that disaster exposure (stress) would influence depression directly and indirectly, through deterioration of social support. LISREL analyses indicated that postdisaster declines in social embeddedness and nonkin support mediated the immediate and delayed impact of disaster stress. No evidence was found for the mediational role of kin support. Findings are in accord with conceptualizations of social support as an entity reflecting dynamic transactions among individuals, their social networks, and environmental pressures.
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              Trauma exposure and post-traumatic stress disorder in the general population.

              To examine the lifetime prevalence of trauma experiences and post-traumatic stress disorder (PTSD). Questionnaire-assessed PTSD, the type of traumatic event experienced, perceived trauma impact, and trauma frequency in 1824 randomly selected men and women. PTSD lifetime prevalence was estimated at 5.6% with a 1 : 2 male-to-female ratio, in spite of men reporting greater trauma exposure. The highest PTSD risk was associated with sexual and physical assault, robbery and multiple trauma experiences. Controlling for trauma type did not account for gender differences, while controlling for experienced distress did. The conditional probability for PTSD varied as a function of trauma type, frequency and impact of the event, with increased rates associated with prevalent trauma exposure and higher perceived distress. The latter accounted for the gender effect, suggesting that gender differences in PTSD in part represent a generally greater vulnerability to stress in women. Copyright 2004 Blackwell Munksgaard.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Funding acquisitionRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                29 May 2020
                2020
                : 15
                : 5
                : e0232477
                Affiliations
                [1 ] CentERdata, Tilburg, The Netherlands
                [2 ] Tilburg University’s Network on Health and Behavior (Nethlab), Tilburg, The Netherlands
                [3 ] HealthnetTPO, Amsterdam, The Netherlands
                [4 ] Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands
                [5 ] Victim Support Foundation (FSH), Den Haag, The Netherlands
                [6 ] Clinical Psychology, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands
                [7 ] Foundation Arq, Diemen, The Netherlands
                Monash University, AUSTRALIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-0221-6281
                http://orcid.org/0000-0001-8744-4322
                Article
                PONE-D-19-34383
                10.1371/journal.pone.0232477
                7259781
                32469880
                97829682-476c-4de6-84fb-1fc8d7e25a1b
                © 2020 van der Velden et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 8 January 2020
                : 15 April 2020
                Page count
                Figures: 0, Tables: 5, Pages: 19
                Funding
                Funded by: Fonds Slachtofferhulp
                Award Recipient :
                This study is part of the VICTIMS-project (Victims in Modern Society-project) of the Victims Support Foundation (Fonds Slachtofferhulp, the Netherlands), and granted by the Victims Support Foundation.
                Categories
                Research Article
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Biology and Life Sciences
                Psychology
                Emotions
                Social Sciences
                Psychology
                Emotions
                Social Sciences
                Sociology
                Criminology
                Crime
                Theft
                People and Places
                Population Groupings
                Ethnicities
                European People
                Dutch People
                Research and Analysis Methods
                Mathematical and Statistical Techniques
                Statistical Methods
                Regression Analysis
                Physical Sciences
                Mathematics
                Statistics
                Statistical Methods
                Regression Analysis
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Neuropsychiatric Disorders
                Anxiety Disorders
                Post-Traumatic Stress Disorder
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Neuroses
                Anxiety Disorders
                Post-Traumatic Stress Disorder
                People and places
                Geographical locations
                Europe
                European Union
                Netherlands
                Research and Analysis Methods
                Research Design
                Survey Research
                Questionnaires
                Custom metadata
                The data are collected using the LISS panel. Further information about all conducted surveys and regulations for free access to the data can be found at www.lissdata.nl (in English). The LISS panel has received the international Data Seal of Approval (see https://www.datasealofapproval.org/en/). Health survey in 2016 see: https://www.dataarchive.lissdata.nl/study_units/view/658 Social Integration and Leisure survey 2016, see https://www.dataarchive.lissdata.nl/study_units/view/672 Data of the VICTIMS survey conducted in 2018, see ( https://www.dataarchive.lissdata.nl/study_units/view/1).

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