Trauma exposure and posttraumatic stress disorder in a large community sample of Chinese adults

This study investigated the prevalence and related factors of trauma exposure and probable posttraumatic stress disorder (PTSD) in adults from a Chinese community sample.

Participants were 7218 adults recruited from Jiangxi and Hunan provinces in China. Life Events Checklist and Posttraumatic Stress Disorder Checklist for DSM-5 were used to screen lifetime trauma exposure and PTSD symptoms, respectively. Participants' adverse and positive childhood experiences, behavioral inhibition, depression, insomnia, psychotic-like experiences (PLEs) and ADHD symptoms were also measured. Multiple regressions were performed to examine the correlates of PTSD.

Approximately 67.1% of participants reported one traumatic event; 27.1% experienced four or more. Participants recruited from private school, male, young age, low socioeconomic status, and poor physical health were associated with more trauma-exposure. The prevalence of PTSD was 2.1% in the total sample and 3.1% among the trauma-exposed. Among participants with PTSD, 53.6% were screened as depression, 54.3% had insomnia, 65.6% had one to three PLEs, 12.6% had four to seven PLEs, and 26.5% were screened as likely ADHD, and 5.3% highly likely ADHD. Younger age, being less educated, poor marriage quality and physical health, more adverse childhood experiences, behavioral inhibition and less positive childhood experiences were associated with increased risk of PTSD among the trauma exposed. After adjustment of these related factors, depression, insomnia, PLEs and ADHD were related to PTSD.

PTSD is relatively prevalent among Chinese community population. Childhood experiences, behavioral inhibition, and concurrent mental health account for individual differences in vulnerability to PTSD.