Traumatic life events and development of post-traumatic stress disorder among female factory workers in a developing country

Abstract

Background:

Post-traumatic stress disorder (PTSD) may be more prevalent and burdensome in developing countries.

Aims:

The goals of this study were to (1) determine the prevalence of PTSD, (2) identify types and number of traumas related to screening positive for PTSD and (3) determine other sociodemographic risk factors and health/medical conditions that may be correlated to PTSD among garment-factory workers and a comparable working population in Bangladesh.

Method:

A survey was administered to a convenient sample of 607 lower socio-economic status (SES) working women in Bangladesh, 310 of who were garment workers. The primary outcome PTSD was measured by the PTSD Checklist. The Life Events Checklist determined the number and type of traumatic events.

Results:

The prevalence of PTSD was found to be 17.79% – 7.25% in garment workers and 21.55% in the comparison worker group. In multivariate analysis, PTSD was found to be significantly associated with age, income, chronic pain and number of stressful events. Participants between 45–50 years of age had the greatest odds of reporting PTSD – 15.68 fold (95% confidence interval (CI) = 4.08, 60.29) compared with those younger than 24 years. PTSD was more common in those with lower income (2,000–4,000 taka) (odds ratio (OR) = 1.60; 95% CI = 0.79, 3.26), who had chronic pain (OR = 2.48; 95% CI = 1.51, 4.07) and who experienced over three traumatic life events (OR = 11.25; 95% CI = 4.59, 27.59). The mean number of traumatic events experienced by this entire population was 4.9 with PTSD being more likely in those who experienced physical assault (OR = 6.35; 95% CI = 4.07, 9.90), who caused serious harm or death to someone else (OR = 4.80; 95% CI = 1.36, 16.87) and who had exposure to combat or war (OR = 4.76; 95% CI = 1.17, 19.34).

Conclusion:

Undiagnosed and untreated PTSD impacts the quality of life and decrease worker productivity among working-age women in this developing country.

Keywords

Factory workers PTSD developing country

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References

Arnberg

F. K.

Bergh Johannesson

Michel

P. O.

(2013) Prevalence and duration of PTSD in survivors 6 years after a natural disaster. Journal of Anxiety Disorders, 27, 347–352.

Atwoli

Stein

D. J.

Koenen

K. C.

Mclaughlin

K. A.

(2015). Epidemiology of post-traumatic stress disorder: Prevalence, correlates and consequences. Current Opinion in Psychiatry, 28, 307–311.

Axinn

W. G.

Ghimire

D. J.

Williams

N. E.

Scott

K. M.

(2013). Gender, traumatic events, and mental health disorders in a rural Asian setting. Journal of Health and Social Behavior, 54, 444–461.

Begum

(2010). Harassment of women garment workers in Bangladesh. Journal of the Bangladesh Agricultural University, 8, 291–296.

Blanchard

E. B.

Jones-alexander

Buckley

T. C.

Forneris

C. A.

(1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy, 34, 669–673.

Breslau

Anthony

J. C.

(2007). Gender differences in the sensitivity to posttraumatic stress disorder: An epidemiological study of urban young adults. Journal of Abnormal Psychology, 116, 607–611.

Cardozo

B. L.

Bilukha

O. O.

Crawford

C. A.

Shaikh

Wolfe

Gerber

M. L.

Anderson

(2004). Mental health, social functioning, and disability in postwar Afghanistan. JAMA,292, 575–584.

Fitch

Villanueva

Quadir

M. M.

Sagiraju

H. K.

Alamgir

(2015). The prevalence and risk factors of post-traumatic stress disorder among workers injured in Rana Plaza building collapse in Bangladesh. American Journal of Industrial Medicine, 58, 756–763.

Fitch

T. J.

Moran

Villanueva

Sagiraju

H. K. R.

Quadir

M. M.

Alamgir

(2017). Prevalence and risk factors of depression among garment workers in Bangladesh. International Journal of Social Psychiatry, 63, 244–254.

10.

Herrman

Swartz

(2007). Promotion of mental health in poorly resourced countries. The Lancet, 370, 1195–1197.

11.

Hoge

C. W.

Riviere

L. A.

Wilk

J. E.

Herrell

R. K.

Weathers

F. W.

(2014). The prevalence of post-traumatic stress disorder (PTSD) in US combat soldiers: A head-to-head comparison of DSM-5 versus DSM-IV-TR symptom criteria with the PTSD checklist. The Lancet Psychiatry, 1, 269–277.

12.

Husarewycz

M. N.

El-gabalawy

Logsetty

Sareen

(2014). The association between number and type of traumatic life experiences and physical conditions in a nationally representative sample. General Hospital Psychiatry, 36(1), 26–32.

13.

Karam

E. G.

Friedman

M. J.

Hill

E. D.

Kessler

R. C.

McLaughlin

K. A.

Petukhova

… Koenen

K. C.

(2014). Cumulative traumas and risk thresholds: 12-month PTSD in the World Mental Health (WMH) surveys. Depression and Anxiety, 31, 130–142.

14.

Kessler

R. C.

Aguilar-Gaxiola

Alonso

Chatterji

Lee

Ormel

… Wang

P. S.

(2009). The global burden of mental disorders: An update from the WHO World Mental Health (WMH) surveys. Epidemiologia e Psichiatria Sociale, 18(1), 23–33.

15.

Kessler

R. C.

Chiu

W. T.

Demler

Merikangas

K. R.

Walters

E. E.

(2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62, 617–627.

16.

Kessler

R. C.

Sonnega

Bromet

Hughes

Nelson

C. B.

(1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.

17.

Keyes

K. M.

Mclaughlin

K. A.

Demmer

R. T.

Cerdá

Koenen

K. C.

Uddin

Galea

(2013). Potentially traumatic events and the risk of six physical health conditions in a population-based sample. Depression and Anxiety, 30, 451–460.

18.

Kodali

(2015). Depression in developing countries. The Yale Global Health Review. Retrieved from https://yaleglobalhealthreview.com/2015/05/16/depression-in-developingcountries/

19.

Lépine

J. P.

Briley

(2011). The increasing burden of depression. Neuropsychiatric Disease and Treatment, 7(Suppl. 1), 3–7.

20.

Miller

K. E.

Rasmussen

(2010). War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks. Social Science & Medicine, 70(1), 7–16.

21.

National Comorbidity Survey. (2005). NCS-R appendix tables: Table 1: Lifetime prevalence of DSM-IV/WMH-CIDI disorders by sex and cohort. Table 2: Twelve-month prevalence of DSM-IV/WMH-CIDI disorders by sex and cohort. Retrieved from http://www.hcp.med.harvard.edu/ncs/publications.php

22.

Norris

F. H.

Murphy

A. D.

Baker

C. K.

Perilla

J. L.

Rodriguez

F. G.

Rodriguez Jde

(2003). Epidemiology of trauma and posttraumatic stress disorder in Mexico. Journal of Abnormal Psychology, 112, 646–656.

23.

Ormel

Von korff

Burger

Scott

Demyttenaere

Huang

Y. Q.

… Kessler

(2007). Mental disorders among persons with heart disease – Results from world mental health surveys. General Hospital Psychiatry, 29, 325–334.

24.

Resick

P. A.

Nishith

Weaver

T. L.

Astin

M. C.

Feuer

C. A.

(2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70, 867–879.

25.

Richardson

L. K.

Frueh

B. C.

Acierno

(2010). Prevalence estimates of combat-related post-traumatic stress disorder: Critical review. The Australian and New Zealand Journal of Psychiatry, 44(1), 4–19.

26.

The World Bank. (2011). GDP per capita, PPP (current international $). Retrieved from http://data.worldbank.org/indicator/ny.gdp.pcap.pp.cd?order=wbapi_data_value_2014wbapi_data_valuewbapi_data_value-last

27.

The World Bank. (2014). Bangladesh. Retrieved from http://data.worldbank.org/country/bangladesh