ORIGINAL PAPER Traumatic events and their relative PTSD burden in Northern Ireland: a consideration of the impact of the ‘Troubles’ Finola Ferry • Brendan Bunting • Samuel Murphy • Siobhan O’Neill • Dan Stein • Karestan Koenen Received: 8 April 2013 / Accepted: 6 August 2013 / Published online: 20 August 2013 Ó Springer-Verlag Berlin Heidelberg 2013 Abstract Purpose Over a 30-year period in its recent history, daily life in Northern Ireland (NI) was characterised by civil violence, colloquially termed as the ‘Troubles’. The current report examines exposure to 29 traumatic event types and the associated conditional prevalence of post-traumatic stress disorder (PTSD) among the Northern Ireland popu- lation, with a focus on the impact of traumatic events that were characteristic of the NI ‘Troubles’. Method Results presented are based on analysis of data from the Northern Ireland Study of Health and Stress (NISHS). The NISHS is a representative epidemiological study of mental health among the NI adult population (N = 4,340) and part of the World Mental Health Survey Initiative. Results Perpetration of violence, physical assault by a spouse or partner and private events were the event types associated with the highest conditional prevalence of PTSD. Despite this elevated risk, collectively these events accounted for just 16.8 % of the overall public burden of PTSD, given their low prevalence among the general population. Events that were characteristic of civil conflict, including unexpected death of a loved one, witnessing death or a dead body or someone seriously injured and being mugged or threatened with a weapon accounted for the highest proportion of the overall public health burden of PTSD (18.6, 9.4 and 7.8 %, respectively). These find- ings are a feature of the higher prevalence of these events among the general population coupled with their moderate to above average risk of PTSD. Conclusions Despite the formal end to conflict in NI in 1999, a substantial proportion of the adult population continue to suffer the adverse mental health effects of chronic trauma exposure. Given rates of recovery of PTSD in the absence of evidence-based treatments, it is likely that the legacy of mental ill health associated with conflict, if not adequately addressed, will endure for many years. Keywords PTSD Á Mental health Á Trauma Á Conflict Á Northern Ireland Background Northern Ireland (NI) is a small western European country of some 1.7 million inhabitants [1] with a turbulent recent history. While situated on the island of Ireland, NI is cur- rently part of the United Kingdom. From 1969, the country was embroiled in a bitter civil conflict between Irish republicans (predominantly from the Catholic community) opposed to British rule and aggrieved at denial of civil rights, and British loyalists (predominantly from the Prot- estant community, committed to the union of NI with the United Kingdom). Over a 30-year period daily life in many F. Ferry (&) MRC Trial Methodology Hub, Room MB119, Bamford Centre for Mental Health and Wellbeing, University of Ulster, Magee Campus, Northland Road, Londonderry BT48 7JL, Northern Ireland, UK e-mail: f.ferry@ulster.ac.uk B. Bunting Á S. Murphy Á S. O’Neill Bamford Centre for Mental Health and Wellbeing, University of Ulster, Londonderry, Northern Ireland, UK D. Stein Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa K. Koenen Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA 123 Soc Psychiatry Psychiatr Epidemiol (2014) 49:435–446 DOI 10.1007/s00127-013-0757-0