Effect of directness of exposure and trauma type on Mental Health Literacy of PTSD

Abstract

Background: Research has demonstrated that Post-Traumatic Stress Disorder (PTSD) is one of the most widely recognized mental disorders, but recognition is affected by trauma type.

Aims: The current study investigated the effect of direct versus indirect exposure to traumatic event and trauma types on Mental Health Literacy (MHL) of PTSD.

Methods: Two hundred and thirty-three participants were asked to identify the mental health problem after presentation of an unlabeled vignette describing a character experiencing PTSD symptoms. The six vignettes described the same symptoms but differed in directness (direct/indirect exposure) and trauma type (rape, military combat or man-made disaster). It was hypothesized that (1) recognition rate would be higher in direct than indirect conditions, and (2) higher in military combat, followed by man-made disaster, and lowest in rape condition.

Results: Overall, correct recognition of PTSD was 42.5%. Recognition in direct exposure vignettes was significantly higher than indirect, supporting the first hypothesis. The second hypothesis was only partly supported. While PTSD recognition in rape vignettes was significantly lower than the other two scenarios, no difference was found between combat and man-made disaster trauma types.

Conclusions: Our findings implied under-recognition of PTSD, with lack of awareness of different causes of PTSD and of PTSD from indirect trauma exposure. The latter finding is important in the light of DSM-V revisions to diagnostic criteria for PTSD.

Keywords:

• Post-Traumatic Stress Disorder (PTSD)
• Mental Health Literacy
• trauma
• indirect exposure

Declaration of interest

There is no conflict of interest in this paper.

Notes

¹ PTSD has been re-classified as a “trauma-and-stress-related disorder” in DSM-V (APA, 2013), comprising four symptom clusters: intrusion, arousal, avoidance, and negative cognition and mood.

² For subsequent analyses, a binary variable was created indicating university level education or not. Participants’ age was divided into three categories, 18–29, 30–39 and 40+, and participants nationality was divided into three categories, Chinese (n = 109), Europeans including British (n = 83) and other nationalities (n = 41).

³ See, for example: https://www.gov.uk/government/publications/terrorist-attacks-in-paris-support-for-people-affected.