Neuroticismo y trastorno por estrés postraumáticoun estudio meta-analítico.

Abstract

ABSTRACT Background: Post-Traumatic Stress Disorder (PTSD) and Neuroticism have important public health implications. There is scientific evidence to suggest that neuroticism may increase the risk of PTSD when exposed to a traumatic event. However, there are conflicting reports in the scientific literature. Objective: To examine the evidence regarding the influence of Neuroticism in the development of PTSD in people who have experienced a traumatic experience. Methods: Search strategy: A systematic review was conducted in different databases (PsycINFO, PsycArticle, MEDLINE, EMBASE, TripDataBase and Google Scholar) using the following keywords: "Neuroticism AND PTSD OR post-traumatic stress disorder". Selection and data extraction: The inclusion criteria were: (a) Empirical studies (case-control, cohort or cross-sectional studies) which report on measures of Neuroticism as a personality trait and symptoms or diagnosis of PTSD assessed, both, through any empirically validated scale or by established diagnostic criteria according to DSM or ICD, using the same instrument throughout the whole sample; (b) studies reporting the direct relationship between Neuroticism and PTSD by quantitative data in subjects who have been exposed to a traumatic event; (c) articles written in English or Spanish; (d) studies published until October 2011. The selection was made by two independent reviewers. Two independent reviewers, following a pre-established encoding protocol, coded the studies characteristics, including a checklist of methodological quality criteria. Disagreements were solved by consensus. Statistical Analysis: After a descriptive analysis of the selected studies, the mean effect size was calculated with random-effects model. To assess heterogeneity, a Forest Plot was built and the Cochran's Q statistic and the I2 index were calculated. The publication bias, the effect of potential moderator variables and the percentage of explained variance were also estimated. Finally, a predictive model was calculated including the most significant moderating variables. Outcomes: From 201 identified studies, out of which 36 studies (34 papers) were included and data extracted. The mean effect size found (r + = 0.371, 95% CI: 0.327 - 0.414) suggests a positive correlation of medium to high intensity by Cohen's criterion, though with a high heterogeneity. There is no threat of publication bias. Analysis of moderator variables leads to the construction of a predictive model with three variables: assessing ethnicity, age and sample type (clinical vs. community). Discussion: Current evidence supports the Neuroticism as a risk factor to develop PTSD after being exposed to a stressful event. This association becomes greater with increasing age, in community samples and in studies that do not assess the ethnicity. Future research should address this issue, as well as the influence of other potential moderating variables. Difficulties in the identification of selection criteria in detected studies and the small number of them reporting the moderating variables are among the limitations of this meta-analysis. Its strengths are the systematic search in more than three independent databases, the selection and evaluation of each paper by two independent researchers using a standardized data extraction form and the analysis of publication bias. Conclusions: Current evidence supports that Neurocticism can be considered as a risk factor to develop a PTSD in people exposed to a traumatic event. These findings should be considered in the development of future preventive actions and treatment interventions.