A meta-analysis of rape education programs.

Meta-analysis of evaluation studies of rape education programs aimed at college students examined which program characteristics were related to participants' rape-supportive attitude change. Linear regression analyses revealed that: (a) published studies yielded greater attitude change than dissertations, presentations, or unpublished studies; (b) attitude change declined over time; and (c) men in mixed-gender groups experienced less attitude change after interventions than men in single-gender groups. Implications for the development of effective rape education programs are discussed.

The childhood trauma questionnaire in a community sample: psychometric properties and normative data.

Interpretation of research on the prevalence and sequelae of childhood trauma has been hindered by the use of assessment instruments with unknown psychometric properties. Thus, we examined the psychometric properties of a new childhood trauma measure, the Childhood Trauma Questionnaire (CTQ). The CTQ has demonstrated strong psychometric properties in clinical samples; limited information exists on its psychometric properties in community samples. Therefore, we explored the factor structure and reliability of the CTQ in a community sample and calculated normative data. Consistent with previous literature, a 5-factor model best described the CTQ, with a hierarchical model also providing excellent fit. Additionally, the CTQ demonstrated acceptable internal consistency. Overall, our findings suggest that the CTQ is appropriate for use in a community sample.

Gender differences in susceptibility to posttraumatic stress disorder.

We examined data from a community survey of trauma exposure and DSM-IV PTSD in Winnipeg, Canada to explore factors associated with the higher rate of PTSD in women than men. Women were found to be at significantly increased risk for PTSD following exposure to serious trauma (odds ratio approximately 5), even when sexual trauma--which predominates in women--was excluded (odds ratio approximately 3). Adjusting for gender differences in the number of lifetime traumata, or in the likelihood of the trauma being associated with particular reactions to or consequences of the event (i.e. thinking that one would be killed or seriously injured; sustaining a serious physical injury; seeing someone else seriously injured or killed) did not result in a lessening of the PTSD risk in women. Women were found to be at increased risk for PTSD following nonsexual assaultive violence (e.g. mugging or other physical attack) but not following non-assaultive trauma (e.g. fire, witnessing injury to others). Understanding the basis of (and parameters for) this increased susceptibility to PTSD in women compared to men following trauma exposure should be a priority for future traumatic stress research.

Obsessive-compulsive disorder in the community: an epidemiologic survey with clinical reappraisal.

OBJECTIVE: To examine the prevalence of obsessive-compulsive symptoms and DSM-IV obsessive-compulsive disorder (OCD), the authors conducted a telephone survey of 2,261 adults in four regions of Canada. METHOD: Trained lay interviewers administered a modified version of the OCD section of the Comprehensive International Diagnostic Interview. A subsample of respondents with probable cases and probable subclinical cases of OCD was then blindly reinterviewed by research personnel experienced in the assessment of OCD, using the Structured Clinical Interview for DSM-IV and the Yale-Brown Obsessive Compulsive Scale, to confirm the diagnosis and gauge the severity of OCD. RESULTS: The weighted 1-month prevalence of OCD in the entire sample according to the lay interviews was 3.1%. Upon clinical reappraisal, the 1-month prevalence estimate of OCD dropped to 0.6%; an additional 0.6% had subclinical OCD. The mean Yale-Brown Obsessive Compulsive Scale score of the individuals with OCD was 19.0 (SD = 4.6, median = 21); for those with subclinical OCD, the mean score was 15.4 (SD = 2.4, median = 14). Common reasons for overdiagnosis of OCD by the lay interviewers were inappropriate labeling of worries or concerns as obsessions and overestimating the degree of interference or distress attributable to obsessive-compulsive symptoms. CONCLUSIONS: OCD, while hardly a rare condition, may be somewhat less prevalent than had been believed on the basis of previous surveys. Additional studies are needed to substantiate these findings and to delineate precisely the extent of disability and reduced quality of life attributable to OCD (and OCD variants) in the community.

Full and partial posttraumatic stress disorder: findings from a community survey.

OBJECTIVE: Full and partial posttraumatic stress disorder (PTSD) following trauma exposure were examined in a community sample in order to determine their prevalence and their relative importance and functional significance. METHOD: A standardized telephone interview with a series of trauma probes and a DSM-IV PTSD checklist was administered to a random sample of 1,002 persons in a midsized Midwestern Canadian city. The authors determined current (i.e., 1-months) prevalence rates of full PTSD, i.e., all DSM-IV criteria, and partial PTSD, i.e., fewer than the required number of DSM-IV criterion C symptoms (avoidance/numbing) or criterion D symptoms (increased arousal). Additional questions about interference with functioning were also posed. RESULTS: The estimated prevalence of full PTSD was 2.7% for women and 1.2% for men. The prevalence of partial PTSD was 3.4% for women and 0.3% for men. Interference with work or school was significantly more pronounced in persons with full PTSD than in those with only partial symptoms, although the latter were significantly more occupationally impaired than traumatized persons without PTSD. CONCLUSIONS: These findings in an epidemiologic sample underscore observations from patient and military groups that many traumatized persons suffer from a subsyndromal form of PTSD. These persons with partial PTSD, although somewhat less impaired than persons with the full syndrome, nonetheless exhibit clinically meaningful levels of functional impairment in association with their symptoms. This subthreshold form of PTSD may be especially prevalent in women. Additional study of partial PTSD is warranted.

Public-speaking fears in a community sample. Prevalence, impact on functioning, and diagnostic classification.

BACKGROUND: Recent epidemiologic studies have revealed that social phobia is more prevalent than has been previously believed. An unresolved issue is the extent to which public-speaking fears constitute a recognizable form of social phobia in a community sample and, moreover, to what extent these fears are associated with functional morbidity. METHODS: To examine the prevalence and impact of public-speaking fears and their relationship to social phobia in a community sample, we conducted a randomized telephone survey of 499 residents of Winnipeg, Manitoba, a medium-sized midwestern metropolitan area. RESULTS: One third of the respondents reported that they had excessive anxiety when they spoke to a large audience. The onset of fears was early (ie, 50%, 75%, and 90% by the ages of 13, 17, and 20 years, respectively). Anxious cognitions about public speaking included the following fears: doing or saying something embarrassing (64%), one's mind going blank (74%), being unable to continue talking (63%), saying foolish things or not making sense (59%), and trembling, shaking, or showing other signs of anxiety (80%). In total, 10% (n = 49) of the respondents reported that public-speaking anxiety had resulted in a marked interference with their work (2%), social life (1%), or education (4%), or had caused them marked distress (8%). Twenty-three persons (5%) had public-speaking anxiety in isolation (ie, without evidence of additional kinds of social fears). CONCLUSIONS: These data support the inclusion of severe forms of public-speaking fears within the social phobia construct and, furthermore, suggest that public-speaking anxiety may have a detrimental impact on the lives of many individuals in the community.

Childhood physical and sexual abuse in patients with anxiety disorders and in a community sample.

OBJECTIVE: The authors investigated whether histories of childhood physical or sexual abuse were reported more frequently in a clinical sample of patients with anxiety disorders than in a matched community comparison sample. METHOD: A standardized interview with an extensive series of trauma probes was administered to 125 patients with DSM-IV anxiety disorders (panic disorder, social phobia, or obsessive-compulsive disorder) and to 125 age- and gender-matched subjects drawn from a random community sample. RESULTS: Childhood physical abuse was higher among both men (15.5%) and women (33.3%) with anxiety disorders than among comparison subjects (8.1%). Childhood sexual abuse was higher among women with anxiety disorders (45.1%) than among comparison women (15.4%) and was higher among women with panic disorder (60.0%) than among women with other anxiety disorders (30.8%). CONCLUSIONS: These findings confirm the association between anxiety disorders and reported childhood physical and sexual abuse and extend earlier findings by pointing to a particular association between sexual abuse and panic disorder in women.

Setting diagnostic thresholds for social phobia: considerations from a community survey of social anxiety.

OBJECTIVE: The goal of this study was to gain a broader perspective on social anxiety in the community than has been achieved by epidemiologic surveys to date. METHODS: The authors conducted a telephone survey of social anxiety among 526 randomly selected respondents in a medium-sized Canadian city. RESULTS: Sixty-one percent of the respondents reported being much or somewhat more anxious than other people in at least one of the seven social situations surveyed. Speaking to a large audience (i.e., public speaking) was the most frequently feared situation (endorsed by 55.0% of the respondents), followed by speaking to a small group of familiar people (24.9%), dealing with people in authority (23.3%), attending social gatherings (14.5%), speaking to strangers or meeting new people (13.7%), and eating (7.1%) or writing (5.1%) in front of others. When the threshold for caseness was systematically modified--by altering the required level of psychosocial interference or distress or by including or excluding subjects with pure public speaking phobia--the rate of "social anxiety syndrome" in the community varied from 1.9% to 18.7%; 7.1% was the prevalence when the criteria were set to conform with DSM-III-R. CONCLUSIONS: Social anxiety is common in the community, but precise delineation of the prevalence of "social phobia" depends heavily on where the diagnostic threshold is set. If DSM-III-R criteria had been applied in previous epidemiologic studies, it is likely that those studies would have documented prevalences of social phobia that are several times as high as the currently accepted rates.

Perceived crime, fear of crime, and walking alone at night.

This study examined longitudinal patterns in public opinion about crime, fear of crime, and walking alone at night. Data sets from the Winnipeg Area Study of 4050 randomly selected adults who were interviewed in their homes were used. The data reflect high concern by respondents for increasing crime rates. Analysis suggests that perceived crime in the city and in Canada were not associated with fear of crime and walking alone at night; perceived crime in respondents' neighborhoods showed a weak association. Implications for measures of perceived crime are discussed.