Lifetime trauma exposure is common [2-5]. It is even more prevalent in American Indian populations, where such exposure rises to the level of a significant public health concern [6,7]. For example, American Indians are more likely to die as a result of accidental injuries, homicide, and motor vehicle accidents than those in the general population [8]. Their rates of criminally violent victimization are twice those of African Americans and 2.5 times those of Whites [9]. The results reported in the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP), a unique population-based survey of two large American Indian reservation communities [10,11], corroborate these earlier findings. Participants more often experienced physical assaults and witnessed traumatic events, or reported that loved ones had experienced such events, than did their counterparts in the baseline National Comorbidity Survey (NCS) [3].
