Racial/ethnic variation in trauma-related psychopathology in the United States: a population-based study

Nov 1, 2018Psychological medicine

Differences in trauma-related mental health problems among racial and ethnic groups in the United States

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Abstract

Among a national sample of 13,775 adults, racial/ethnic minorities exhibit lower odds of developing mental disorders compared to Whites.

Traumatic event exposure varied by racial/ethnic group, with Asians most affected by organized violence and Blacks experiencing the highest rates of various types of trauma.
Racial/ethnic minorities had lower odds ratios for the onset of depression, anxiety, and substance use disorders compared to Whites.
Differences in traumatic event exposure or vulnerability to mental health issues did not explain the observed lower rates of psychopathology among minorities.
Asians showed a lower likelihood of developing post-traumatic stress disorder (PTSD) after trauma, while Blacks had a higher likelihood compared to Whites.

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BACKGROUND: The prevalence of mental disorders among Black, Latino, and Asian adults is lower than among Whites. Factors that explain these differences are largely unknown. We examined whether racial/ethnic differences in exposure to traumatic events (TEs) or vulnerability to trauma-related psychopathology explained the lower rates of psychopathology among racial/ethnic minorities.

METHODS: We estimated the prevalence of TE exposure and associations with onset of DSM-IV depression, anxiety and substance disorders and with lifetime post-traumatic stress disorder (PTSD) in the Collaborative Psychiatric Epidemiology Surveys, a national sample (N = 13 775) with substantial proportions of Black (35.9%), Latino (18.9%), and Asian Americans (14.9%).

RESULTS: TE exposure varied across racial/ethnic groups. Asians were most likely to experience organized violence - particularly being a refugee - but had the lowest exposure to all other TEs. Blacks had the greatest exposure to participation in organized violence, sexual violence, and other TEs, Latinos had the highest exposure to physical violence, and Whites were most likely to experience accidents/injuries. Racial/ethnic minorities had lower odds ratios of depression, anxiety, and substance disorder onset relative to Whites. Neither variation in TE exposure nor vulnerability to psychopathology following TEs across racial/ethnic groups explained these differences. Vulnerability to PTSD did vary across groups, however, such that Asians were less likely and Blacks more likely to develop PTSD following TEs than Whites.

CONCLUSIONS: Lower prevalence of mental disorders among racial/ethnic minorities does not appear to reflect reduced vulnerability to TEs, with the exception of PTSD among Asians. This highlights the importance of investigating other potential mechanisms underlying racial/ethnic differences in psychopathology.

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Racial/ethnic variation in trauma-related psychopathology in the United States: a population-based study

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