Sociocultural Mechanisms Associated with Posttraumatic Stress Disorder: An Analysis of Latino Veterans

Abstract

Although numerous risk factors are related to the development of PTSD and the severity of PTSD symptoms, ethnicity - especially factors related to Latino ethnicity - has recently been reported as a risk factor in numerous studies. The purpose of this study was to identify and examine social and cultural factors that may contribute to the development of PTSD and increased PTSD symptom severity among Latino veterans through the development of a cultural model of traumatic stress. Grounded in stress and coping theory, the cultural model was broken down into three phases: 1) pre-trauma; 2) peri-trauma; and 3) post-trauma. Mail surveys were used to gather information from a sample of Latino veterans enrolled in the VA Palo Alto Health Care System. Approximately half of the respondents met criteria for PTSD and the other half did not, with a total of 146 completed surveys. Bivariate analyses, hierarchical logistic regression, and hierarchical multiple regression were used to analyze the data. Variables analyzed in this study included demographics, childhood adversity, acculturation, familialism, perceived racial and ethnic discrimination, combat exposure, combat injury, peri-trauma coping (i.e., dissociation), post-trauma coping (i.e., emotion-focused, problem-focused, dysfunctional), post-trauma social support, and fatalism. Although most of the cultural variables were correlated with PTSD in the bivariate analyses, they were no longer significant in the multivariate models when stronger predictors were included. Combat exposure and stress appraisal predicted the development of PTSD and PTSD symptom severity in both multivariate models. Whereas combat injury predicted PTSD development, it was not a strong predictor of PTSD symptom severity. Peri-trauma dissociation and dysfunctional post-trauma coping predicted PTSD symptom severity, but were not strongly correlated with the development of PTSD. Although the cultural factors and many of the social factors did not individually predict PTSD or severity of PTSD symptoms in the full models, the conceptual model as a whole performed well and the individual predictors worked well together as sets to predict PTSD and PTSD symptom severity. This indicates that factors related to ethnicity may be of importance in models predicting PTSD and PTSD symptom severity and should be considered.