Demographic and clinical associations of worst event trauma among a nationally representative sample of individuals with PTSD

Posttraumatic stress disorder (PTSD) is a highly heterogenous disorders with approximately 636,120 different symptom combinations. The goal of the present study was to examine the association of worst-event trauma with demographic characteristics, psychiatric comorbidities, and PTSD symptoms among a large nationally representative sample of US adults with lifetime PTSD (N = 2339). The study used data from the National Epidemiologic Survey on Alcohol and Related Conditions-III to examine correlates of worst-event trauma using survey-weighted logistic and linear regression analyses. Childhood sexual assault was associated with female sex (AOR = 3.46, 95 % CI 2.34–5.11), being a sexual minority (AOR = 2.03, 95 % CI 1.24–3.31), younger age (β = −0.23, SE = 0.05), lower income (β = −0.27, SE = 0.07), comorbid social anxiety disorder (AOR = 1.57, 95 % CI 1.09–2.26), panic disorder (AOR = 1.70, 95 % CI 1.23–2.35), agoraphobia (AOR = 1.86, 95 % CI 1.22–2.83), borderline personality disorder (AOR = 1.49, 95 % CI 1.12–1.97), and greater PTSD severity (β = 0.55, SE = 0.07. Adult sexual assault was associated with being single (AOR = 0.48, 95 % CI 0.28–0.80) and greater PTSD symptoms (β = 0.10, SE = 0.02). Bodily injury was associated with being male (AOR = 0.61, 95 % CI 0.44–0.84) and lower odds of depression (AOR = 0.54, 95 % CI 0.37–0.77). The present study's findings indicate the needs for greater examination of PTSD criteria and how index trauma may influence factors such as comorbidities and symptoms. Findings also indicate the need for longitudinal studies to better parse the heterogeneity that exists in PTSD diagnosis.