Trauma exposure correlates among patients receiving care in federally qualified health centers

Author:

Blanchard Brittany E.1ORCID,Bluett Ellen J.2,Johnson Morgan1,Zimberoff Anya3,Fortney John C.14ORCID

Affiliation:

1. Department of Psychiatry and Behavioral Sciences University of Washington School of Medicine Seattle Washington USA

2. Family Medicine Residency of Western Montana University of Montana Missoula Montana USA

3. HealthPoint SeaTac SeaTac Washington USA

4. Veterans Affairs (VA) Health Systems Research Center of Innovation for Veteran‐Centered and Value‐Driven Care VA Puget Sound Health Care System Seattle Washington USA

Abstract

AbstractOver 80% of adults in the general population experience trauma. Rates of patients with posttraumatic stress disorder (PTSD) are high in primary care settings and are likely to be even higher in federally qualified health centers (FQHCs). Trauma exposure has been linked to psychiatric symptoms and physical health comorbidities, though little research has focused on FQHC patients. This study addresses this by examining clinical and sociodemographic correlates of specific trauma types among FQHC patients. We analyzed secondary data from patients who screened positive for PTSD and were receiving health care in FQHCs in a clinical trial (N = 978). Individuals who did versus did not experience a specific trauma type were compared using between‐group tests. In the sample, 91.3% of participants were exposed to a DSM‐5 Criterion A traumatic event, with 79.6% experiencing two or more trauma types. Witnessing a life‐threatening event (57.3%) and physical assault (55.7%) were the most common traumatic experiences. Physical health comorbidities and worse physical health functioning were associated with a higher likelihood of exposure to all trauma types, with effect sizes larger than PTSD, ds = 0.78–1.35. Depressive and anxiety symptoms were also associated with a higher likelihood of experiencing nearly all trauma types to a lesser magnitude. People of color, OR = 2.45, and individuals experiencing financial inequities, OR = 1.73, had higher odds of experiencing serious accidents as well as other trauma types. The findings highlight the need for trauma‐informed care, including routine trauma and PTSD screening, for FQHC patients.

Funder

National Institute on Drug Abuse

Patient-Centered Outcomes Research Institute

National Center for Advancing Translational Sciences

Publisher

Wiley

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