Epidemiology of PTSD: Prevalence Across Countries - Research Paper

Introduction

Epidemiology refers to the study of the determinants and the distribution of a disease in a given population. Posttraumatic stress disorder (PTSD) is considered as a psychological condition that is disabling in nature and develops after exposure to a traumatic situation or event (Swick & Ashley, 2017). Numerous studies have conducted in assessing the prevalence of PTSD. Atwoli, Stein, Koenen and McLaughlin (2015) asserted that the prevalence of PTSD is significantly similar across countries.

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In most cases, PTSD is associated with adults, such as those in the military. However, women and children also play a substantial demographic among those diagnosed with PTSD. Children develop PTSD when exposed to traumatic events. However, treating PTSD in children using adult diagnostic criteria could cause misdiagnosis of PTSD in children (La Greca, 2007).

The following study will critique and review two published research articles. In reviewing the articles, the study will focus on the hypothesis, working assumptions, population, study design, research study base, and population sampling techniques, data type, statistical data and finally a conclusion of the review.

Article 1: Elevated Risk of Posttraumatic Stress in Sexual Minority Youths: Mediation by Childhood Abuse and Gender Nonconformity

The above article had the objective of determining if lifetime risks of PTSD were higher in heterosexual youths versus sexual minority. Another aim is examining whether disparities in PTSD were accounted for by childhood abuse and whether sexual-orientation discrepancies were explained by childhood gender nonconformity.

Study Hypothesis The null hypothesis for the study was that gender nonconformity was a determinant of sexual orientation variances in an encounter to abuse happening before adolescence.

Population

A population is a group of subjects sharing common traits such as gender (Bryman, 2016). A target population is one which is of interest to a study and one from which a study wishes to make conclusions (Bryman, 2016). A fixed population is permanent in relative context and defined by an event such survivors of a given bomb blast. On the other hand, a dynamic population is characterized by current status and membership is temporary (Bryman, 2016).

The study above used a closed cohort population where a given event guarantees the membership to the given population, and no exit is possible for a subject. Data from a longitudinal cohort comprising 16882 children from the US was used. Specifically, the 2007 wave was used for the study, and the mean age of the respondents was 22.7 years. PTSD symptoms, sexual orientation and childhood maltreatment were assessed using a sample size of 9784.

Study Design

Study design refers to a process in which the statistical analysis, as well as the methodology of a study, is organized to facilitate acceptance or rejection of the null hypothesis and ensure that the conclusions drawn are valid (Parab & Bhalerao, 2010). A study design is categorized broadly into observational and experimental or both. Observation design has no intervention such as drug treatment whereas experimental study involves administering an intervention to subjects and documenting effects of the intervention (Parab & Bhalerao, 2010).

An observational design is used in the above study. The subjects used are from a previous study, "Growing Up Today Study", that had been conducted in the US. In the study, no intervention such as the administration of a drug is evident, and the study only analyses data from the previous research.

Research Study Base

Research base refers to the patients, staffs and institution that are eligible to take part in a clinical trial. Also known as the reference population, it is the identified population whose experience in a defined period forms the study's data source (Martin, 2009).

The research base is US children belonging to women involved in the Nurses' Health Study II. The respondents were 19-27 years when the primary data was collected.

Population Sampling

The sampling approach for research could be a probability or a non-probability approach. Probability method selects subjects randomly to achieve objectivity in sample selection (Acharya, Prakash, Saxena & Nigam, 2013). Probability methods include simple, stratified and systematic random sampling. On the other hand, a non-probability sampling method is dependent on the subjective judgment made by the researcher (Acharya et al., 2013). Non probability techniques include: convenience sampling, where the easiest to access units within a population are selected; proportional quota sampling, which ensures groups in the population are proportionate in the chosen sample; purposive sampling, where selection depends on researchers judgment; and snowballing technique, used in hard to access groups and the already identified subjects are requested to nominate other subjects from their acquaintances (Acharya et al., 2013).

A case study sample has been selected from the population-based case study with 9369 respondents. In constructing the measures of the study, the researcher can be argued to use non-probability sampling technique, purposive sampling. For example, in measuring the childhood abuse measure, sexual abuse was coded either as absent or present. In this case, the subjects in our sample were categorized into these groups since they fulfilled the purpose of the research measure. Participants were therefore grouped in the different categories of the various measures according to the purpose.

Data Type

Two data types exist, primary and secondary data. Primary data (ad hoc data) is first-hand data collected by the researcher from primary sources (Bryman, 2016). This data has several advantages, such as low manipulation risks. Secondary data (antecedent data) is collected for use in other studies, but a researcher chooses to use the already available data in a study (Bryman, 2016).

Secondary data has been used for the study. Data from a population-based study in the US has been utilized in this research study.

Statistical Data

Statistical data could either use descriptive statistics or inferential statistics. Descriptive statistics involve the use of methods requiring collection, organizing, presenting and reporting data sets to describe various characteristics of the collected data set (Bryman, 2016). It is used mainly in descriptive studies to identify trends and patterns but not in defining cause and effect among elements. Inferential statistics facilitate estimation of features of a given population explicitly based on sample results (Bryman, 2016). The analysis is performed on the data and the results used in making informed decisions. The findings can be generalized to the entire population.

A descriptive statistic is utilized in this study. The statistics used in this study predict the prevalence of PSTD in sexual minority youths but does not define any cause and effects. This means the study utilized descriptive statistics and not inferential statistics.

Conclusion

The research findings indicated that young adults within the sexual minority are prone to higher risks of PTSD with the main contributing factor being the higher exposure to childhood abuse. Those working with the youths must ensure abuse treatment and prevention measures for children that are gender non-conforming as well as sexual minority youths.

I agree with the results of this study as they are in correspondence with the previous research by Roberts, Austin, Corliss, Vandermorris and Koenen (2010) that PTSD risks are higher in sexual minorities in their late adolescence.

One limitation for this study is that retrospective reporting reports were relied on, which could have errors and therefore, bias estimates. An opportunity for further research is that there was good accordance when childhood nonconformity was reported with independent ratings using home-based video recordings. As such, future research studies could use this kind of reporting.

Article 2: Military-tailored yoga for veterans with posttraumatic stress disorder. Military medicine, 183(5-6), e223-e231.Study Hypothesis

This study has the null hypothesis that yoga intervention that is trauma-sensitive for veterans and military personnel with PTSD.

Population

The population used in this study is a dynamic population where although a stated event guarantees membership, an exit is possible if the state seizes to exist. In this case, the population consists of PTSD diagnosed veterans who are post-9/11. Membership may seize if the PTSD is treated.

Study Design

The study design is experimental. Since experimental study involves administering an intervention to subjects and documenting effects of the response, this study is experimental since it required yoga intervention providing yoga class appropriate for military personnel and specifically combat veterans. Data for the research was also collected at baseline and then after a seven-week duration. Self-report questionnaires are administered at pre, and post-intervention stages and results of the intervention evaluated. The study was also a pre-post study for the military.

Research Study Base

The research base for this study is veterans of post-9//11conflicts and veteran service organization. They are the reference population.

Population Sampling

A probability sampling technique has been utilized in this study. All participants that received flyers and advertisements and were eligible for participation had equal chances to be part of the participants. The sampling technique could also be argued to be nonprobability in that the identified participants to enrol in the study were further selected based on purpose, which was defined by the eligibility criteria. Eligible participants had to be 18 years or older who had been deployed in Afghanistan or Iraq and with a threshold level PTSD.

Data Type

Primary data was collected in this study, as the participants selected for the study were administered with pre and post-intervention questionnaires. The information collected was, therefore, first-hand information.

Statistical Data

Inferential statistics were utilized for the study as well as descriptive statistics. Both the baseline and postintervention data were subjected to normality tests. Statistical test such as paired t-test was performed for the measures before and after the intervention to determine any significant change following yoga intervention.

Conclusion

The results of the study indicated decreased PTSD symptoms after the pre-post study using yoga intervention that was trauma-sensitive. The study concluded that trauma-sensitive yoga intervention is effective when applied to PSTD diagnosed veterans.

One of the limitations is that the sample size used was small, and there was a high drop-out rate. The future opportunity lies in using a large sample size in research in this area, which will ensure that the steep drop out rate is well adressed. Cushing and Braun (2018) support the findings of this study in that they reported mind-body therapies to be effective in reducing PTSD. Again, Herron and Rees (2017) indicated that transcendental meditation interventions reduced PTSD among veterans. As such, interventions of PTSD symptoms are effective in reducing the symptoms in military and veterans.

References

Acharya, A. S., Prakash, A., Saxena, P., & Nigam, A. (2013). Sampling: why and how of it? Indian Journal of Medical Specialities, 4(2). doi:10.7713/ijms.2013.0032

Atwoli, L., Stein, D. J., Koenen, K. C., & McLaughlin, K. A. (2015). Epidemiology of posttraumatic stress disorder: prevalence, correlates and consequences. Current opinion in psychiatry, (4), 307-311. doi:10.1097/YCO.0000000000000167

Bhalerao, S., & Parab, S. (2010)....