Relationships among Traumatic Experiences, Posttraumatic Stress Symptoms, and Mental Health-related Characteristics in Young Adults

Kyunghyun Lee; Hyekyung Jo; Sunah Kim

doi:10.12934/jkpmhn.2018.27.2.85

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Lee, Jo, and Kim: Relationships among Traumatic Experiences, Posttraumatic Stress Symptoms, and Mental Health-related Characteristics in Young Adults

Original Article

J Korean Acad Psychiatr Ment Health Nurs 2018;27(2):85-97.

Published online: 17 June 2018

DOI: https://doi.org/10.12934/jkpmhn.2018.27.2.85

Relationships among Traumatic Experiences, Posttraumatic Stress Symptoms, and Mental Health-related Characteristics in Young Adults

Kyunghyun Lee¹, Hyekyung Jo¹, Sunah Kim²

¹College of Nursing, Yonsei University, Seoul, Korea

²College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea

Corresponding author: Kim, Sunah https://orcid.org/0000-0001-5922-6598 College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-3210, Fax: +82-2-364-5027, E-mail: PSY0962@yuhs.ac

Received 15 February 201825 March 2018 Accepted 28 May 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to investigate the level of traumatic experiences, posttraumatic stress symptoms and mental health-related characteristics in young adults and identify relationships among the variables.

Methods

In this descriptive cross-sectional study, data were collected through a Web-based survey (N=568). Structured instruments included valid measures of traumatic experiences, posttraumatic stress symptoms, depression, somatization symptoms, insomnia, and alcohol use. Collected data were analyzed using descriptive statistics, t-tests, x² tests, ANOVA, and Pearson correlation coefficient with SPSS statistics 23.

Results

Among study participants, 76.8% reported traumatic experiences. The severity of trauma was associated with high levels of posttraumatic stress symptoms, depression, somatization symptoms, insomnia, and alcohol use. Women showed more severe posttraumatic stress and depressive symptoms than men. There were positive correlations for trauma experiences with posttraumatic stress symptoms, depression, somatization symptoms, and insomnia.

Conclusion

Findings indicate the need to develop nursing intervention programs to relieve posttraumatic stress symptoms and improve mental health related characteristics targeting young adults, and to establish a national policy that addresses characteristics of trauma experienced in Korea.

Keywords: Stress disorder, Posttraumatic, Depression, Mental health, Young adult

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Table 1.

Differences in Mental Health-related Symptoms by Socio-d emographics (N=568

Variables	Categories	n (%)	Posttraumatic stress symptom		Depression		Somatization symptom		Insomnia		Alcohol use
Variables	Categories	n (%)	M± SD	t or F (p)	M± SD	t or F (p)	M± SD	t or F (p)	M± SD	t or F (p)	M± SD	t or F (p)
			19.79±18.20		16.53±11.61		9.13±8.16		9.35±4.56		8.79±7.95
Gender	Male	283 (49.8)	17.75±18.24	-2.68	15.03±11.08	-3.07	8.47±8.26	-1.95	9.25±4.77	-0.54	9.27±7.66	1.43
	Female	285 (50.2)	21.82±17.97	(.008)	18.01±11.95	(.002)	9.80±8.02	(.052)	9.45±4.35	(.587)	8.31±8.22	(.154)
Age	19~22 ^a	108 (19.0)	20.77±18.70	0.63	16.06±11.72	0.11	7.56±6.52	2.99	8.70±4.60	1.36	6.48±6.06	5.83
	23~26 ^b	253 (44.6)	18.84±17.18	(.528)	16.67±10.89	(.893)	9.18±8.66	(.051)	9.49±4.58	(.257)	9.15±7.97	(.003)
	27~29 ^c	207 (36.4)	20.45±19.17		16.53±11.62		9.14±8.17		9.52±4.53		9.57±8.60	b, c＞ a^†
Academic	High school	175 (30.7)	20.02±18.89	0.90	17.36±11.86	1.29	9.37±7.80	0.79	9.00±4.81	0.78	7.39±7.58	2.86
status	2 or 3yr college	84 (14.9)	21.19±18.31	(.441)	17.94±12.53	(.278)	9.44±8.18	(.500)	9.61±4.63	(.502)	9.44±8.46	(.036)
	4yr college	285 (50.2)	18.87±17.45		15.73±11.31		8.73±8.08		9.31±7.82		9.31±7.82
	Graduate work	24 (4.2)	24.25±21.53		15.04±9.70		11.13±11.34		10.29±4.50		10.63±9.47
Marital state	Married	41 (7.2)	22.98±18.78	-1.16	16.34±11.72	0.79	10.12±7.65	0.95	9.54±4.61	0.76	8.56±7.98	0.80
	Unmarried	527 (92.8)	19.55±18.15	(.246)	16.54±11.62	(.913)	9.06±8.20	(.424)	9.34±4.57	(.793)	8.81±7.96	(.845)
Religion	Yes	195 (34.3)	19.33±17.89	-0.44	17.48±11.73	1.41	9.90±8.65	1.57	9.20±4.41	-0.59	7.94±7.64	-1.84
	No	373 (65.7)	20.04±18.68	(.660)	16.03±11.53	(.157)	8.74±7.89	(.118)	9.44±4.65	(.558)	9.24±8.08	(.065)
Occupation	Student ^a	242 (42.6)	19.79±17.68	0.73	15.64±10.72	0.94	8.36±7.33	1.23	8.98±4.45	0.82	7.71±6.59	3.12
	Office work	141 (24.8)	18.41±17.62	(.570)	36.81±12.02	(.439)	9.26±8.15	(.294)	9.58±4.65	(.510)	9.04±7.87	(.015)
	Service work ^b	34 (6.0)	24.26±22.55		18.26±13.60		10.53±9.17		10.15±4.43		12.23±10.05	b＞ a^†
	Profession	33 (5.8)	20.61±18.86		15.64±10.94		9.48±8.48		9.67±4.36		9.03±7.79
	Other	118 (20.8)	19.93±18.48		17.77±12.46		10.10±9.31		9.53±4.81		9.64±9.57
Socioeconomic	c High	26 (4.5)	23.27±20.69	4.94	16.61±11.69	14.03	14.23±11.16	5.77	10.30±4.80	4.23	10.00±9.47	2.00
state	Moderate ^a	352 (62.0)	17.93±16.93	(.007)	14.63±10.75	(＜.001)	8.28±7.67	(.003)	8.92±4.16	(.015)	9.19±7.88	(.136)
	Low ^b	190 (33.5)	22.78±19.70	b＞ a^†	20.04±12.36	b＞ a^‡	10.29±8.37	b＞ a^†	10.02±5.13	b＞ a^†	7.88±7.82
Smoking	Yes	100 (17.6)	25.50±21.25	3.05	18.01±12.48	1.40	11.60±10.13	2.78	10.87±4.87	3.69	14.92±9.36	7.50
	No	468 (82.4)	18.57±17.26	(.003)	16.22±11.42	(.162)	8.61±7.60	(.006)	9.03±4.44	(＜.001)	7.48±6.96	(＜.001)

^† Dunnett T3;

^‡ Sheffé test.

Table 2.

Descriptive of Stressful Life Events Screening Questionnaire (N=568)

Traumatic experience	Experienced by participants^†
	No	Yes	Once	2~3 times	4 times or more	Male	Female	χ² (p)
	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	n (%)	χ² (p)
	132 (23.2)	436 (76.8)	390^‡ (68.7)^§	196^‡ (34.5)^§	111^‡ (19.5)^§	204 (46.8)	232 (53.2)	6.91 (.009)
Q1. Have you ever had a life-threatening illness?	412	156	134	16	6	90	66	5.32
Q1. Have you ever had a life-threatening illness?	(72.5)	(27.5)	(23.6)	(2.8)	(1.1)	(44.1)^\|\|	(28.4)^¶	(.021)
Q2. Were you ever in serious accidents? (e.g. Car or train accidents, fire, natural disasters)	372	196	158	33	5	109	87	4.01
	(65.5)	(34.5)	(27.8)	(5.8)	(0.9)	(53.4)^\|\|	(37.5)^¶	(.045)
Q3. Was physical force or a weapon ever used against you in a robbery or mugging?	484	84	63	18	3	48	36	2.11
	(85.2)	(14.8)	(11.1)	(3.2)	(0.5)	(23.5)^\|\|	(15.5)^¶	(.146)
Q4. Has an immediate family member, romantic partner, or very close friend died as a result of accident, homicide, or suicide?	379	189	149	33	7	91	98	0.31
	(66.7)	(33.3)	(26.2)	(5.8)	(1.2)	(44.6)^\|\|	(42.2)^¶	(.573)
Q5. Have you ever been forced into sex or sexual assaultive?	497	71	44	20	7	26	45	5.65
	(87.5)	(12.5)	(7.8)	(3.5)	(1.2)	(12.7)^\|\|	(19.4)^¶	(.017)
Q6. Have you ever had someone touch your body (legs, hips, chest, genitalia, etc.) against your will?	339	229	114	74	41	82	147	30.15
	(59.7)	(40.3)	(20.1)	(13.0)	(7.2)	(40.1)^\|\|	(63.4)^¶	(＜.001)
Q7. When you were a child, did a parent, caregiver, or other person ever slap you repeatedly, beat, or otherwise attack or harm you?	491	77	28	17	32	44	33	1.90
	(86.4)	(13.6)	(4.9)	(3.0)	(5.7)	(21.6)^\|\|	(14.2)^¶	(.167)
Q8. Have you ever been physically assaulted by friends, family members, or strangers who hit, kicked, or harassed you recently?	507	61	37	14	10	42	19	9.89
	(89.2)	(10.8)	(6.5)	(2.5)	(1.8)	(20.6)^\|\|	(8.2)^¶	(.002)
Q9. Have you been repeatedly neglected, bullied, or teased by a family member or someone close?	393	175	83	45	47	74	101	5.74
	(69.2)	(30.8)	(14.6)	(7.9)	(8.3)	(36.3)^\|\|	(43.5)^¶	(.016)
Q10. Have you ever witnessed the death of another person, a serious accident, or sexual and physical violence?	441	127	90	26	11	76	51	6.65
	(77.6)	(22.4)	(15.9)	(4.6)	(1.9)	(37.3)^\|\|	(22.0)^¶	(.010)
Q11. Have you ever had a serious injury or life-threatening situation (e.g. war, detention, hostage experience, etc.)?	527	41	28	10	3	32	9	14.08
	(92.8)	(7.2)	(4.9)	(1.8)	(0.5)	(15.7)^\|\|	(3.9)^¶	(＜.001)
Q12. Have you ever experienced an unbearable, frightening, or shocking event other than the above?	404	164	111	36	17	78	86	0.47
	(71.1)	(28.9)	(19.5)	(6.3)	(3.0)	(38.2)^\|\|	(37.1)^¶	(.492)

^† To allow multiple answers to respond to both type and frequency of trauma experienced;

^‡ Number of people who experienced one, 2~3 times, or 4 times or more traumas regardless of the type and frequency of trauma;

^§ The percentages are based on the number of total person (N=568);

^| |The percentages are based on the number of male respondents(n=204);

^¶ The percentages are based on the number of female respondents(n=232).

Table 3.

Proportions over Cutoff Scores of Mental Health-related Symptoms (N=568)

Variables	Cutoff	Total	Male	Female	χ² (p)
Variables	Cutoff	n (%)	n (%)	n (%)	χ² (p)
Posttraumatic stress symptom	≥25	207 (36.4)	93 (44.9)	114 (55.1)	3.12 (.077)
Depression	≥21	189 (33.3)	78 (41.3)	111 (58.7)	8.29 (.004)
Insomnia	≥8.5	281 (49.5)	140 (49.8)	141 (50.2)	0.00 (.999)
Alcohol use	≥12	156 (27.5)	83 (53.2)	73 (46.8)	0.98 (.321)

Table 4.

Differences in Mental Health-related Symptoms by Trauma Severity (N=568)

Variables	Non-trauma group^a	Low severity trauma group^†,b	Moderate severity trauma group^‡,c	High severity trauma group^§,d	F (p)	Post hoc (Dunnett T)
Variables	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	F (p)	Post hoc (Dunnett T)
	132 (23.2)	142 (25.0)	154 (27.1)	140 (24.7)
Posttraumatic	9.08±13.79	13.18±13.93	22.01±15.62	34.16±18.44	70.00 (＜.001)	c＞a, b
stress symptom						d＞a, b, c
Depression	12.56±9.99	13.59±9.46	17.17±11.56	22.55±12.56	23.29 (＜.001)	d＞c＞a, b
Somatization	6.32±7.55	7.33±6.45	9.38±7.15	13.35±9.53	22.28 (＜.001)	c＞a
symptom						d＞a, b, c
Insomnia	7.37±3.81	8.23±3.72	9.66±4.03	12.02±5.20	31.82 (＜.001)	d＞c＞a, b
Alcohol use	7.02±6.87	7.78±6.89	8.90±7.50	11.37±9.63	8.14 (＜.001)	d＞a, b

^† Low severity trauma group (one to two points based on stress life event screening questionnaire, SLESQ): People who experienced one or two traumas, or minimum one trauma two or three times;

^‡ Moderate severity trauma group (three to five points based on SLESQ): People who experienced up to three traumas, or minimum one trauma four or more times;

^§ High severity trauma group (over six points based on SLESQ): People who experienced up to six traumas, or minimum three traumas two or three times or minimum two traumas four or more times.

Table 5.

Correlation among Traumatic Experience and Mental Health-related Symptoms (N=568)

Variables	1	2	3	4	5	6
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
1. Traumatic experience	1
2. Posttraumatic stress symptom	.52 (＜.001)	1
3. Depression	.36 (＜.001)	.57 (＜.001)	1
4. Somatization symptom	.35 (＜.001)	.51 (＜.001)	.62 (＜.001)	1
5. Insomnia	.43 (＜.001)	.56 (＜.001)	.58 (＜.001)	.57 (＜.001)	1
6. Alcohol use	.21 (＜.001)	.26 (＜.001)	.21 (＜.001)	.39 (＜.001)	.29 (＜.001)	1

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