Grant: Foundation Grant

Adverse Childhood Experiences; Alcohol Use Disorders; Anxiety Disorders; Depression; Epidemiology; Health Services; Military And Veterans; Physical Health Problems; Posttraumatic Stress Disorder; Suicide

<html> <body> <p> <strong>Context.</strong> Although stress is a recurring and omnipresent problem, there are major gaps in knowledge about the hallmark condition related to traumatic stress (i.e., posttraumatic stress disorder [PTSD]). Over 70% of Canadians are exposed to traumatic events (e.g., physical injury, assault) in their lives. Although most are resilient, a substantial minority experience subsequent emotional problems.</p> <p>The diagnosis of PTSD may be given when a group of symptoms, such as disturbing flashbacks, avoidance of situations or memories associated with the event, hyperarousal, and changes in cognitions continue for more than a month after the traumatic event. Much knowledge about PTSD has come from non-Canadian samples, is inconsistent, and is based on cross-sectional studies that preclude causal inferences.</p> <p>Major gaps exist in the literature on the incidence, longitudinal course, impact, and treatment needs of PTSD in Canadians. It is essential to understand the trajectory of PTSD within Canada&rsquo;s unique demographic, sociocultural and health care system influences.</p> <p> <br> <strong>Research Objectives:</strong>&nbsp;<br> 1) Define the incidence and longitudinal course of PTSD in Canadian samples.<br> 2) Develop prediction tools to identify those at risk for incident and persistent PTSD.<br> 3) Define the impact of PTSD on subsequent risk for negative health outcomes (e.g., disability, addictions, physical or mental health problems, and mortality).<br> 4) Describe health care use and treatment needs among people with PTSD.<br> <br> Two cohorts will provide complementary information on the longitudinal consequences of trauma and PTSD among vulnerable groups.</p> <p> <br> <strong><em>Cohort I. Civilians with Acute Trauma Exposure at High Risk for PTSD</em></strong><em>.</em> We will recruit a representative sample of 1000 participants presenting to acute care settings for physical injuries, sexual assault, or with serious physical illness. We will conduct in-person interviews over two years and link each participant&rsquo;s self-report data with population-based administrative healthcare data collected by Manitoba Health to assess long-term outcomes for participants.</p> <p> <br> <strong><em>Cohort II. Longitudinal Mental Health Survey of Active Military Personnel and Veterans.</em></strong> Combat and peacekeeping-related PTSD is an important public health issue in active Canadian military and veterans. In 2002, Statistics Canada and the Canadian Forces conducted the first nationally-representative mental health survey. In collaboration with key stakeholders, we plan to conduct a 14-year follow-up of these participants (<em>n~</em>4500) to examine longitudinal exposure to stress and subsequent health outcomes.<br> </p> <p> <strong>Expertise</strong>. A team of experts in PTSD, mental disorders, physical injuries, chronic physical conditions, epidemiology, biostatistics, pharmacy, and active military/veteran health will work together to address the research questions<br> </p> <p> <strong>Mentorship plan.</strong> Trainees from psychiatry, psychology, surgery and epidemiology will be involved in the program of research. With weekly team meetings, an annual summer school training program for students, and strong links with professional societies, students have rich opportunities to develop research skills.<br> </p> <p> <strong>Impact.</strong> In the short term, the program of research will determine the causes of PTSD, the impact of PTSD on health outcomes, and treatment needs of people with PTSD in Canada. In the long-term, understanding these important questions will improve recognition and treatment of PTSD across health sectors, and will ultimately improve the lives of people with PTSD.</p> </body> </html>