ABSTRACT
Background: Living in urban places has been associated with a higher risk of psychopathology as well as with altered hypothalamus-pituitary-adrenal (HPA) axis and consequently altered cortisol response, but studies have concentrated mainly in high-income countries population. The role of other hormones such as testosterone, implicated in stress response and with human social behaviors, have not yet been investigated. The aim of this study was to compare symptoms of psychopathology as well as cortisol and testosterone in response to traumatic images between urban and suburban people in a middle-income country. Methods: A sample of 67 women and 55 men (N = 122, 18-45 years) from urban and suburban places of Mexico participated in the study. We quantified salivary cortisol and testosterone in response to images with traumatic and violent content (basal, 15, 30, and 45 min after images). Participants answered a general information questionnaire and the Symptom Checklist-90-R to assess their psychopathological traits. We performed Generalized Estimating Equation Models to analyze hormonal levels and MANOVAs to compare differences in participants' psychopathology symptoms. Area under the curve respect to ground (AUCG) of hormonal levels and sex differences were also compared. Results: Suburban citizens showed no cortisol response, whereas urban people showed a cortisol peak 15 min after the image's exposure; however, suburban people had higher AUCG and basal levels compared to urban ones. Contrastingly, testosterone levels declined in all participants excepting the urban women, who showed no testosterone response. Although similar testosterone profile, AUCG levels were higher in urban than suburban men. Participants living in suburban areas had higher scores of somatizations, obsessive-compulsive, and interpersonal sensitivity, as well as more sleep disorders than participants living in urban areas. Conclusion: This study offers novel evidence about differences in cortisol and testosterone responses to a social stressor and in mental health indicators between a population of urban and suburban citizens, highlighting the impact of urbanization process on physiological and psychological outcomes in a middle-income country.
ABSTRACT
Resumen: Objetivo: Describir la ocurrencia de eventos potencialmente traumáticos (EPT) en estudiantes de preparatoria, medir la sintomatología postraumática subumbral en quienes aún sufren repercusiones de un EPT y asociar la sintomatología con variables sociodemográficas y características del EPT. Material y métodos: Estudio transversal analítico realizado en un muestra por conveniencia de 1000 estudiantes de tres preparatorias del Estado de México. Se aplicó la Escala para Estrés Postraumático en Universitarios Mexicanos. Se evaluó la presencia de síntomas y su frecuencia; la asociación con variables explicativas se realizó con modelos de regresión logística y cuantílica, respectivamente. Resultados: 80% reportó un EPT. De éstos, 79% aún sufría repercusiones actuales y casi la mitad de ellos presentó sintomatología. El sexo, número de eventos y características del EPT (cambios percibidos y gravedad) se encontraron asociados. Conclusiones: Los resultados sugieren intervenir tempranamente para disminuir el riesgo de desarrollar un trastorno.
Abstract: Objective: Describe the occurrence of potentially traumatic events (PTE) in high-school students, measure subthreshold post-traumatic symptomatology in those who still experience PTE repercussions and associate the symptomatology with sociodemographic and PTE characteristics. Materials and methods: Analytic transversal study carried out in a convenience sample of one thousand students from three high schools in the State of Mexico. The Scale for Post Traumatic Stress in University Students was applied. The presence of symptoms, their frequency and their association with explanatory variables was assessed by means of logistic and quantile logistic regression models, respectively. Results: 80% reported PTE. Of this, 79% still experienced current repercussions and almost a half presented symptomatology. Gender, number of events, and PTE characteristics (perceived and grave symptoms) were associated. Conclusions: Results suggest to intervene early to reduce the risk of developing a disorder.
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Stress Disorders, Post-Traumatic/epidemiology , Life Change Events , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Logistic Models , Prevalence , Cross-Sectional Studies , Symptom AssessmentABSTRACT
OBJECTIVE: Describe the occurrence of potentially traumatic events (PTE) in high-school students, measure subthreshold post-traumatic symptomatology in those who still experience PTE repercussions and associate the symptomatology with sociodemographic and PTE characteristics. MATERIALS AND METHODS: Analytic transversal study carried out in a convenience sample of one thousand students from three high schools in the State of Mexico. The Scale for Post Traumatic Stress in University Students was applied. The presence of symptoms, their frequency and their association with explanatory variables was assessed by means of logistic and quantile logistic regression models, respectively. RESULTS: 80% reported PTE. Of this, 79% still experienced current repercussions and almost a half presented symptomatology. Gender, number of events, and PTE characteristics (perceived and grave symptoms) were associated. CONCLUSIONS: Results suggest to intervene early to reduce the risk of developing a disorder.
OBJETIVO: Describir la ocurrencia de eventos potencialmente traumáticos (EPT) en estudiantes de preparatoria, medir la sintomatología postraumática subumbral en quienes aún sufren repercusiones de un EPT y asociar la sintomatología con variables sociodemográficas y características del EPT. MATERIAL Y MÉTODOS: Estudio transversal analítico realizado en un muestra por conveniencia de 1000 estudiantes de tres preparatorias del Estado de México. Se aplicó la Escala para Estrés Postraumático en Universitarios Mexicanos. Se evaluó la presencia de síntomas y su frecuencia; la asociación con variables explicativas se realizó con modelos de regresión logística y cuantílica, respectivamente. RESULTADOS: 80% reportó un EPT. De éstos, 79% aún sufría repercusiones actuales y casi la mitad de ellos presentó sintomatología. El sexo, número de eventos y características del EPT (cambios percibidos y gravedad) se encontraron asociados. CONCLUSIONES: Los resultados sugieren intervenir tempranamente para disminuir el riesgo de desarrollar un trastorno.
Subject(s)
Life Change Events , Stress Disorders, Post-Traumatic/epidemiology , Adolescent , Cross-Sectional Studies , Female , Humans , Logistic Models , Male , Prevalence , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Symptom Assessment , Young AdultABSTRACT
Actualmente la violencia en diferentes ámbitos y contextos afecta de manera preocupante a México. Las experiencias traumáticas, comunes en algunas comunidades, pueden llegar a configurar problemas graves de salud mental en los individuos, entre ellos se cuenta el Trastorno por Estrés Postraumático (TEPT). El tener a la mano escalas que midan tanto los eventos susceptibles de ser traumáticos como la sintomatología postraumática, permitiría una evaluación rápida antes del diagnóstico formal y su utilización, principalmente en estudios epidemiológicos que permitan detectar el impacto de dichos sucesos en las personas y las comunidades. El objetivo del presente estudio consistió en la construcción de una escala de sucesos y síntomas asociados al TEPT en población mexicana universitaria, con el fin de obtener su confiabilidad y validez. Participaron 858 estudiantes de cuatro universidades públicas de Tejupilco, Estado de México. La muestra fue de 669 jóvenes de ambos sexos con edades de 18 a 25 años, quienes contestaron la escala en su totalidad. El índice de confiabilidad se obtuvo con una alfa de Cronbach y la validez de constructo mediante el análisis factorial. El suceso más frecuentemente encontrado fue la experiencia de muerte repentina de algún familiar y/o amigo cercano. La escala, como instrumento de tamizaje, obtuvo índices convenientes para ser aplicada en poblaciones similares. La consistencia interna resultó con una α=.95 y el análisis factorial arrojó cinco factores con una varianza total de 45.15%. Su diseño permite asociar los síntomas del último año a un suceso de vida específico, valorado por el mismo sujeto, como susceptible a ser traumático. Así, se detectó vulnerabilidad en la población juvenil estudiantil a padecer el TEPT o algún otro tipo de trastorno psiquiátrico derivado de los sucesos vividos. La identificación precoz podría sugerir la creación de servicios generales y especializados en salud mental, acompañados de acciones que reconozcan el valor de la Universidad como uno de los principales espacios sociales para jóvenes.
Nowadays violence in different aspects and contexts affects Mexico in a worrying manner. Common traumatic experiences in some communities might configure grave mental health problems in the individuals, among them posttraumatic stress disorder (PTSD). Having scales that measure events susceptible to become traumatic as well as posttrau-matic symptomatology would allow a fast assessment before formal diagnosis, to be mainly used in epidemiological studies that enable detecting the impact of these occurrences in vulnerable people and communities. The objective of the present study was to build a scale of events and symptoms associated to PTSD in a Mexican university population, in views to obtaining its reliability and validity. A total of 858 students from four public universities of Tejupilco, State of Mexico, Mexico, took part; they were between 18 and 25 years of age, and answered the scale in its entirety. The reliability index was obtained by means of Cronbach's alpha and the validity of the construct with factorial analysis. The most frequent event was the experience of sudden death of some relative and/or a close friend. The scale as a screening instrument obtained internal consistency indexes of α=0.95 and the factorial analysis yielded five factors with a total variance of 45.15%. Its design allows associating the symptoms of the previous year to a specific life event, valued by the same subject as susceptible to become traumatic, which permits its utilization on similar populations. The vulnerability of the young student population to suffer PTSD or any other sort of psychiatric disorder from experienced events was verified. Early detection could suggest general and specialized mental health services, accompanied by actions that recognize the value of university as one of the main social spaces for youths.
