Arthur D. Murphy

Sex Differences in Symptoms of Posttraumatic Stress: Does Culture Play a Role?

If gender differences in posttraumatic stress disorder follow from culturally-defined roles and rules, they should be greater in societies that foster traditional views of masculinity and femininity than in societies that adhere to these traditions less rigidly. Data were collected 6 months after Hurricanes Paulina (Acapulco; N = 200) and Andrew (Miami; White n = 135; Black n = 135). In regression analyses predicting scores on the Revised Civilian Mississippi Scale, Sex × Cultural Group interactions emerged for the total scale and for subscales of Intrusion, Avoidance, and Remorse. Only a sex main effect (women higher) emerged for Arousal. Overall, the results indicated that Mexican culture amplified, whereas African American culture attenuated, differences in the posttraumatic stress of male and female disaster victims.

Epidemiology of trauma and posttraumatic stress disorder in Mexico

Prevalence rates of trauma and posttraumatic stress disorder (PTSD) were estimated from a probability sample of 2,509 adults from 4 cities in Mexico. PTSD was assessed according to Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) criteria using the Composite International Diagnostic Interview (CIDI; WHO, 1997). Lifetime prevalence of exposure and PTSD were 76% and 11.2%, respectively. Risk for PTSD was highest in Oaxaca (the poorest city), persons of lower socioeconomic status, and women. Conditional risk for PTSD was highest following sexual violence, but nonsexual violence and traumatic bereavement had greater overall impact because of their frequency. Of lifetime cases, 62% became chronic; only 42% received medical or professional care. The research demonstrates the importance of expanding the epidemiologic research base on trauma to include developing countries around the world.

Placing Age Differences in Cultural Context: A Comparison of the Effects of Age on PTSD After Disasters in the United States, Mexico, and Poland

Criterion symptoms of posttraumatic stress disorder (PTSD) were measured 6–12 months after Hurricane Andrew in the United States (non-Hispanic n = 270), Hurricane Paulina in Mexico (n = 200), and the 1997 flood in Poland (n = 285), using English, Spanish, and Polish versions of the Revised Civilian Mississippi Scale. The samples ranged in age from 18 to 88. Linear and quadratic effects of age were tested by using hierarchical multiple regression, with the effects of gender, trauma, and education controlled. Among Americans, age had a curvilinear relation with PTSD such that middle-aged respondents were most distressed. Among Mexicans, age had a linear and negative relation with PTSD such that younger people were most distressed. Among Poles, age had a linear and positive relation with PTSD such that older people were most distressed. Thus, there was no one consistent effect of age; rather, it depended upon the social, economic, cultural, and historical context of the disaster-stricken setting.

Postdisaster stress in the United States and Mexico: a cross-cultural test of the multicriterion conceptual model of posttraumatic stress disorder.

Data on symptoms of posttraumatic stress disorder (PTSD) were collected 6 months after Hurricanes Paulina (N = 200; Mexico) and Andrew (non-Hispanic n = 270; United States) using the Revised Civilian Mississippi Scale. A 4-factor measurement model that represented the accepted multicriterion conceptualization of PTSD fit the data of the U.S. and Mexican samples equally well. The 4 factors of Intrusion, Avoidance, Numbing, and Arousal correlated significantly and equivalently with severity of trauma in each sample. A single construct explained much of the covariance of the symptom factors in each sample. However, modeling PTSD as a unidimensional construct masked differences between samples in symptom severity. With severity of trauma controlled, the Mexican sample was higher in Intrusion and Avoidance, whereas the U.S. sample was higher in Arousal. The results suggest that PTSD is a meaningful construct to study in Latin American societies.

Violence and PTSD in Mexico Gender and regional differences

ObjectiveWe examined the lifetime prevalence of violence in Mexico and how different characteristics of the violent event effect the probability of meeting criteria for lifetime post-traumatic stress disorder (PTSD).MethodWe interviewed a probability sample of 2,509 adults from 4 cities in Mexico (Oaxaca, Guadalajara, Hermosillo, Mérida) using the Composite International Diagnostic Interview (CIDI).ResultsLifetime prevalence of violence was 34%. Men reported more single-experience, recurrent, physical, adolescent, adulthood, and stranger violence; women more sexual, childhood, family, and intimate partner violence. Prevalence was generally higher in Guadalajara, though the impact was greater in Oaxaca compared to other cities. Of those exposed, 11.5% met DSM-IV criteria for PTSD. Probabilities were highest after sexual and intimate partner violence, higher for women than men, and higher in Oaxaca than other cities.ConclusionsIt is important to consider the characteristics and the context of violence in order to develop effective prevention and intervention programs to reduce the exposure to and impact of violence.

Ecological and Ethical Perspectives on Filial Responsibility: Implications for Primary Prevention with Immigrant Latino Adolescents

This article considers processes from an ecological-ethical viewpoint that may help explain the high rate of school failure and dropout of immigrant Latino adolescents. Drawing from research on filial responsibility and risk and protective processes in this population, a conceptual model is presented that accounts for both negative and positive developmental outcomes. For example, it is speculated that different stressors linked to immigration (e.g., poverty, discrimination) occasion a marked increase in filial responsibility (e.g., assuming the role of interpreter and liaison to the English speaking community, working to earn money for the family) that may compete with other sociocognitive tasks, such as schooling and peer involvement. Yet, Latino youths who perform major caregiving tasks in the family also appear to derive an increased sense of personal and interpersonal competence. The implications of the model for research and prevention programming are discussed.

Severity, timing, and duration of reactions to trauma in the population: an example from Mexico

Normative data describing acute reactions to trauma are few. Of 2509 Mexican adults interviewed with the Composite International Diagnostic Interview, 1241 met trauma exposure criteria for index events occurring more than 1 year previously. The modal response, describing 45%, was a reaction to trauma that was mild (present but below levels of posttraumatic stress disorder symptom criteria), immediate (within the first month), and transient (over within a year). Nonetheless, 29% experienced immediate and serious reactions. Of these, 44% had chronic posttraumatic stress disorder symptoms. Those whose reactions were serious and chronic differed in many ways from those whose reactions were serious but transient. They had more traumatic events during their lives, and their index events were more likely to have occurred in childhood and to have involved violence. They had more symptoms and functional impairment after the trauma and higher levels of depressive and somatic symptoms when data were collected. Psychiatrically significant reactions to trauma persist often enough to justify their detection and treatment. Persons in need of acute intervention can be identified on the basis of the nature and severity of the initial response as well as characteristics of the stressor.

Postdisaster Social Support in the United States and Mexico: Conceptual and Contextual Considerations

A measure of the social support received from family, friends, and outsiders was administered 6 months after Hurricanes Andrew (non-Hispanic n = 270, Hispanic n = 134) and Paulina (Mexican n = 200) and to a normative sample (n = 1,289) representative of urban Mexico. Pilot work with bilingual participants established that equivalent scores were yielded by Spanish and English versions of the instrument. Exemplars of helping showed similar rank-order frequency within samples to form a pattern that was equivalent across samples. A three-factor model that differentiated between emotional, informational, and tangible support described the help received from each source in each sample. Despite the apparent conceptual invariance of social support, levels of support differed strongly. The Paulina sample received more help of each type from each source than the normative sample but less help of each type from each source than the Andrew sample. Within the Andrew sample, Hispanic and non-Hispanic persons did not differ. Rules of relative need and relative advantage that have been found to influence resource distribution at the individual level appear to operate at community and societal levels as well.

Early physical health consequences of disaster exposure and acute disaster-related PTSD

Abstract A sample of adults (N = 666) was interviewed 6 months after the devastating 1999 floods and mudslides in Mexico. Comparisons between sample data and population norms pointed to significant postdisaster elevations in physical health symptoms across a variety of domains. With age, gender, and predisaster mental health and living conditions controlled, severity of exposure was related to higher physical symptoms. The effects of severity of exposure dropped out of the equations when postdisaster posttraumatic stress disorder (PTSD) symptoms were taken into account. The effects of acute PTSD on health symptoms were largely, but not completely, accounted for by concurrent depressed affect, with criterion symptoms reflecting intrusion and arousal most likely to show a specific effect. Although previous research examined stressors from the distant past, here the role of PTSD as a mediator of the trauma–health relation was demonstrated with recent disaster exposure and acute PTSD, in a very different population.

Cross-Cultural and Site-Based Influences on Demographic, Well-being, and Social Network Predictors of Risk Perception in Hazard and Disaster Settings in Ecuador and Mexico

Although virtually all comparative research about risk perception focuses on which hazards are of concern to people in different culture groups, much can be gained by focusing on predictors of levels of risk perception in various countries and places. In this case, we examine standard and novel predictors of risk perception in seven sites among communities affected by a flood in Mexico (one site) and volcanic eruptions in Mexico (one site) and Ecuador (five sites). We conducted more than 450 interviews with questions about how people feel at the time (after the disaster) regarding what happened in the past, their current concerns, and their expectations for the future. We explore how aspects of the context in which people live have an effect on how strongly people perceive natural hazards in relationship with demographic, well-being, and social network factors. Generally, our research indicates that levels of risk perception for past, present, and future aspects of a specific hazard are similar across these two countries and seven sites. However, these contexts produced different predictors of risk perception—in other words, there was little overlap between sites in the variables that predicted the past, present, or future aspects of risk perception in each site. Generally, current stress was related to perception of past danger of an event in the Mexican sites, but not in Ecuador; network variables were mainly important for perception of past danger (rather than future or present danger), although specific network correlates varied from site to site across the countries.