Trauma and Posttraumatic Stress Symptoms in People With Severe Mental Illness: Examining Alternative Measures of Trauma

The current study of 371 community mental health clients with severe mental illness examined correlates of posttraumatic stress symptoms and 4 different approaches to measuring trauma (i.e., index trauma, ever occurred, lifetime occurrence, and subjective distress) while controlling for gender and symptoms of severe mental illness. About 88% of these clients reported at least 1 stressful/traumatic event in their lifetime, with a median of 7 events. Rates of having experienced physical and sexual abuse as well as having witnessed violence and having experienced an unexpected death of a loved one were comparable with previous findings as were gender differences. Using regression, we found that while controlling for gender and psychiatric symptoms and other measures of functioning, only physical abuse was consistently correlated with posttraumatic stress symptom severity along with gender and symptoms of depression. However, when subjective distress measures were used, unexpected death of a loved one was most highly correlated with posttraumatic stress symptoms. Suggestions for future trauma research include more efforts to measure both multiple types and frequencies of trauma as well as to including some "non-Criterion A" stressors while controlling for other psychiatric symptoms. This study was limited by its cross-sectional design and lack of structured interview schedules.