摘要：Objectives. We examined the prevalence of trauma in 2 large American Indian communities in an attempt to describe demographic correlates and to compare findings with a representative sample of the US population. Methods. We determined differences in exposure to each of 16 types of trauma among 3084 tribal members aged 15 to 57 years through structured interviews. We compared prevalence rates of trauma, by gender, across the 2 tribes and with a sample of the US general population. We used logistic regression analyses to examine the relationships of demographic correlates to trauma exposure. Results. Lifetime exposure rates to at least 1 trauma (62.4%–67.2% among male participants, 66.2%–69.8% among female participants) fell at the upper limits of the range reported by other researchers. Unlike the US general population, female and male American Indians exhibited equivalent levels of overall trauma exposure. Members of both tribes more often witnessed traumatic events, experienced traumas to loved ones, and were victims of physical attacks than their counterparts in the overall US population. Conclusions. American Indians live in adverse environments that place them at high risk for exposure to trauma and harmful health sequelae. American Indians live in pervasively adverse social and physical environments that place them at higher risk than many other Americans of exposure to traumatic experiences. 1, 2 Rates of violent victimization of American Indians are more than twice as high as the national average. 3– 6 They also suffer motor vehicle mortalities at a rate 2 to 3 times that among Whites. 7 Deaths due to hypothermia, drowning, falls, poisoning, and burns are considerably more common among American Indians than among other groups. 8 However, the available evidence provides little insight into individual experiences of trauma or variations across communities. Understanding such factors is critical to calculating risks of psychiatric disorder and other health consequences and to planning for their prevention as well as treatment. Our study represented the first systematic assessment of the prevalence of trauma exposure in American Indian communities, specifically tribal members living on or near several large US reservations. Data were collected as part of the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (hereafter “the project”), the largest, most comprehensive study of its kind. Our goals were to (1) describe the nature and frequency of trauma in these 2 American Indian communities, (2) examine the demographic correlates of trauma, and (3) place these findings in a larger context via a comparison with the results of the National Comorbidity Survey (NCS), a large psychiatric epidemiological survey of the US population.
