Ongoing stress may trigger stress symptoms

NEW YORK (Reuters Health) - People with ongoing stress in their lives are more likely to develop post-traumatic stress symptoms after experiencing a traumatic event, a new study shows.

Even stressors not typically thought of as traumatic, such as financial and interpersonal problems, were "strongly associated" with the likelihood that a person would develop such symptoms in the wake of the September 11, 2001 terrorist attacks, Dr. Sandro Galea of the University of Michigan School of Public Health in Ann Arbor and colleagues found. "Interventions that focus on reducing ongoing adversity may help mitigate the consequences of traumatic events," they suggest in the medical journal Epidemiology.

Few studies have looked at risk factors for post-traumatic stress over time, Galea and his team note. Instead most have been cross-sectional, meaning they look at relationships at a single point in time, which makes it impossible to draw conclusions about cause and effect.

To better understand what factors might increase the risk of post-traumatic stress symptoms, the researchers followed 2,752 New Yorkers for 30 months, interviewing them two to four times. Study participants had been recruited to investigate the mental health of New York City residents 6 months after the September 11, 2001 attacks.

The prevalence of posttraumatic stress symptoms rose from 2.1 percent at the first follow-up interview to 14.3 percent by the third follow-up interview, the researchers found. Women and Latinos were more likely to develop these symptoms than men and whites, while low income and low levels of social support also the increased risk.

Past research has also demonstrated a greater vulnerability to post-traumatic stress symptoms among women and Latinos, Galea and his colleagues note, The risk remained greater in these groups even after accounting for factors that also predict post-traumatic stress symptom risk, such as poverty.

"Greater vulnerability to stress among women or difference of experience of pscyhologic symptoms among ethnic/racial groups...may account for the greater risk of posttraumatic stress in these groups," they suggest.

SOURCE: Epidemiology, January 2008.