Download DIAGNOSIS

DIAGNOSIS
Chose a topic in this section:
Criteria
Differential Diagnosis
Common Symptoms of & Responses to Trauma
Other Mental Disorders Associated with Trauma
Criteria:
According to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition,
Text Revision (DSM-IV-TR),
an individual needs to meet these criteria (A-F) to qualify for a diagnosis of PTSD:
A. The individual was exposed to a traumatic event in which both of the following
were present:
(1) the person experienced, witnessed, or was confronted with an event or events
that involved actual
or threatened death or serious injury, or a threat to the physical integrity of self
or others
(2) the person's response involved intense fear, helplessness, or horror.
Note: In children, this may be expressed instead by disorganized or agitated
behavior.
B. The traumatic event is persistently reexperienced in one (or more) of the following
ways:
(1) recurrent and intrusive distressing recollections of the event, including images,
thoughts, or perceptions.
(2) recurrent distressing dreams of the event
(3) acting or feeling as if the traumatic event were recurring (illusions,
hallucinations, dissociative flashbacks, sense of reliving)
(4) intense psychological distress at exposure to internal and external cues that
symbolize or resemble an aspect of the trauma
(5) physiological reactivity on exposure to internal and external cues that symbolize
or resemble an aspect of the trauma
C. Persistent avoidance of stimuli associated with the trauma and numbing of general
responsiveness (not present before trauma),
as indicated by 3 of the following:
(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
(2) efforts to avoid activities, places, or people that arouse recollections of the trauma
(3) inability to recall an important aspect of the trauma
(4) markedly diminished interest or participation in significant activities
(5) feeling of detachment or estrangement from others
(6) restricted range of affect (e.g., unable to having loving feelings)
(7) sense of foreshortened future (e.g., does not expect to have a career, marriage,
children, or normal life span)
D. Persistent symptoms of increased arousal (not present before trauma), as indicated
by 2 or more of the following:
(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response
E. Duration of the disturbance (Criteria B, C, D) is more than 1 month.
F. The disturbance causes clinically significant distress or impairment in social,
occupational, or other important areas.
Specifiers:
»Specifiers allow clinicians to define more uniform groups within the disorder based
on certain features
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor
Above is adapted from DSM-IV-TR (p. 467-468).
Differential Diagnosis:
» If it is unclear which diagnosis is appropriate, this section may help you discern
which is more appropriate.
●PTSD vs. Adjustment Disorder
●PTSD vs. Acute Stress Disorder
●PTSD vs. Malingering
Symptoms & Responses to Trauma (Briere, 2004, DSM-IV-TR, 2000)
Posttraumatic Symptoms
● Intrusive experiences including flashbacks, nightmares, unwanted thoughts or
memories, and reliving sensations
● Avoidance of thinking about or associating with stimuli that remind the victim of the
trauma, emotional numbing
● Increased arousal demonstrated by decreased or poor sleep, muscle tension, irritability,
difficutly concentrating,
and abnormal startle response
Dissociative Symptoms
● Depersonalization (a feeling of detachment from one's self or body)
● Derealization (a feeling of a lost sense of or detachment from reality)
● Fugue state
(sudden, unexpected travel away from one's home with loss of memory of some/all of
one's personal history)
● "Spacing out"
● Amnesia (memory loss)
● Identity confusion
Physical Symptoms
● Motor/Sensory reactions (e.g., paralysis, blindness)
● Psychogenic pain (pain originating from a psychological source)
Sexual Symptoms (especially relevant if trauma is sexual in nature)
● Sexual distress (including sexual dysfunction)
● Sexual fears
Cognitive Symptoms
● Low self-esteem
● Helplessness/hopelessness
● Inflated perception of danger
● Irrational guilt
Common Activities Used to Decrease Distress from Trauma
● Binging-Purging
● Reckless sexual behavior
● Self-mutilation
● Compulsive stealing
● Aggression
Other Mental Disorders Associated with Trauma (Briere, 2004, DSM-IVTR, 2000)
Conversion Disorder - This disorder involves the presence of sensory and/or motor
function symptoms that appear to be
biological in nature. Closer examination reveals that these deficits are due to
psychological factors.
These symptoms are often created or worsened by trauma, usually extreme in nature
(combat experience, losing a loved one)
Somatization Disorder - This disorder consists of a host of bodily symptoms of
varying nature that cannot be fully explained
biologically. Specifically, a person with this disorder must possess at least: four pain
symptoms, two gastrointestinal symptoms, one sexual
symptom, and one pseudoneurological symptom (e.g., paralysis).
This disorder is often the product of repeated childhood abuse, especially of the sexual
nature. The link between trauma and psychologically
manifested physical symptoms is unclear, though possibly a result of the chronic
autonomic arousal involved in multiple traumas.
Major Depressive Disorder (with Psychotic features) - This disorder is characterized
by a depressed mood, loss of interest in activities,
and several other adverse symptoms. In addition,psychotic hallucinations (perceptual
disturbances) or delusions (false beliefs) are also present.
Depressive symptoms often accompany the distressing aftermath of a trauma as the
individual copes with prevelant posttraumatic symptoms
(reexperiencing, increased arousal, avoidance). The psychotic features are thought to be
associated with the dissociative effects of the trauma that
strain the person's link with reality.
Panic Disorder - Recurrent, unexpected panic attacks are a necessary feature of this
disorder as well as continual worry about additional attacks
or the consequences of such attacks.
This disorder is most clearly associated with the hyperarousal symptoms involved in
PTSD. In their study of the relationship between panic and trauma,
Falsetti and Resnick (1997) discovered that 69% of those seeking treatment for trauma
symptomology reported trauma-focused panic attacks.
Borderline Personality Disorder - Described as a profound "pattern of instability of
interpersonal relationships, self-image, and affects, and marked
implusivity", this disorder is traditionally thought to have its origins in childhood. It is
believed that the rewarding of dependent behaviors and punishing of
independent behaviors during development often leads to this skewed sense of self and
relations to others.
Extreme childhood trauma (e.g., neglect, abuse) retards the development process and
distorts the child's ability to relate to self and others.
LINKS
National Center for PTSD
http://www.ncptsd.va.gov/
The National Center for PTSD was created within the Department of Veterans Affairs
in 1989, in response to a Congressional mandate to address the needs of veterans with military-related
PTSD.
PTSD Alliance
http://www.ptsdalliance.org/home2.html
The PTSD Alliance is a group of professional and advocacy organizations that have joined forces to
provide educational resources to individuals diagnosed with PTSD and their loved ones.
The International Society for Traumatic Stress Studies
http://www.istss.org/
ISTSS is an international multidisciplinary, professional membership organization that promotes
advancement and
exchange of knowledge about severe stress and trauma.
US Department of Veterans Affairs
http://www.va.gov/
The VA is the parent organization of the National Center for PTSD. Its Web site provides a wide
range
of information on veterans' benefits and treatment facilities.
Trauma Info Pages
http://www.trauma-pages.com/
David Baldwin's listing of Web resources on clinical and research aspects of trauma responses and
their resolution.
Sidran
http://www.sidran.org/survivor.html
The Sidran Institute is considered to be a leader in traumatic stress education and advocacy. It is a
nationally-focused
nonprofit organization devoted to helping people who have experienced traumatic life events.
National Child Traumatic Stress Network
http://www.nctsnet.org/nccts/nav.do?pid=hom_main
The NCTSN was established to improve access to care, treatment, and services for children and
adolescents exposed to
traumatic events and to encourage and promote collaboration between providers in the field.
National Institute of Mental Health
http://www.nimh.nih.gov/
A wide array of information about mental health issues, for the public, clinicians, and researchers.
RISK FACTORS
Not all trauma survivors develop PTSD. As a result, much attention has been paid to the
factors that make a person vulnerable to
(or protect them from) developing this disorder (Wohlfarth, 2002). Further assessment of
risk factors for PTSD will aid its prevention.
Who's at Risk?
Risk Factors
Statistics
Risk for PTSD
In reality, anyone can develop PTSD. The most reliable predictor of PTSD's onset is a
triggering event, or trauma. As defined by DSM-IV-TR
criteria, a traumatic event is necessary for the diagnosis of PTSD (DSM-IV-TR, 2000).
One study reports that 40% of Americans have experienced
at least one major trauma in their lifetimes and that 8-12% of Americans will suffer from
PTSD at some point (Breslau et al., 1991).
That means that approxiamately one-quarter of those who experience a severe trauma
will subsequently develop PTSD. The National Comorbidity
Survery (NCS), a more comprehensive study, found that 56% of Americans experience a
lifetime trauma while only 8% develop PTSD (Perkonigg et al., 2000).
Futhermore, many other studies have found variable rates of trauma and PTSD in the
population, likely due to the variation among defining criteria.
The prevailing message of these studies is that although PTSD only manifests in a portion
of trauma victims, its overall prevelance is great enough to warrant
significant attention.
Anyone who has been victimized or has witnessed a violent act or who has been
repeatedly exposed to a life-threatening situation.
Survivors of::
● domestic violence
● rape, sexual assault/abuse
● physical assault
● other random violent acts in public (at work, school)
Survivors of unexpected events in everyday life:
● car accidents
● natural disasters
● major catastrophic event (e.g., terrorist attack, plane crash)
● disasters caused by human error (e.g., industrial accidents)
● Children who are neglected or sexually, physically or verbally abused or adults who
were abused as children
● Combat veterans or civilian victims of war
● Those diagnosed with a life-threatening illness or who have had major medical
procedures
● Professionals who respond to victims in trauma situations such as emergency medical
service workers, police, and military
● Those who learn of the sudden, unexpected death of a close friend or relative
These conditions could apply to anyone at certain points in our lives, making PTSD an
unpredictibly common source of distress
(Schiraldi, 2000).
Risk Factors
Nature of Trauma
A victim's vulnerability to PTSD increases if the trauma is:
● sudden, unpredicted
● enduring
● recurring
● pose a real threat of harm
● are multidimensional (pose harm in multiple ways, e.g., natural disaster followed by
drought)
● occur early in life (trauma has a more profound effect on a developing personality)
In addition, three broad temporally-related risk categories have been proposed :
Pre-Trauma, At-Trauma, & Post-Trauma
Pre-Trauma Factors
Individual-related
History of Trauma - Prior trauma, especially where PTSD developed, makes
individuals especially succeptable to repeated bouts with PTSD.
This is likely due to the ease with which unresolved past traumas are recalled and
reexperienced, as well as the likelihood of reenacting
past faulty coping behaviors (Schiraldi, 2000).
Life Stressors - Recent events in a person's life that are not of traumatic magnitude
(e.g., job loss, divorce, financial problems) can weaken the person's
defenses against trauma-induced stress in the same way that hardship can weaken
the immune system.
Poor Coping Skills - Deficits such as low self-esteem, emotionality, and resilience
can increase a person's chance of developing PTSD. The advantage
of this set of vulnerability factors is that they are all learnable. In fact, suffering
through PTSD can actually promote improvement of these deficits (Schiraldi, 2000).
Personality - Certain long-standing traits, such as pessimism and introversion, deny a
person the tools needed to deal with a challenging affliction such
such as PTSD. These, too, are modifiable, but not to the same degree as coping
skills (Schiraldi, 2000).
Genetics - It appears that vulnerability to PTSD can be passed on through
generations, and worsened by certain behaviors such as drug abuse and trauma
experience (Schiraldi, 2000)
Brain Structure - The hippocampus, which plays a role in learning and memory, has
been shown to be damaged in PTSD sufferers (Durand, 2006).
Similarly, research on rodents and primates indicates that stressful stimuli can
induce adverse functional and structural changes in the hippocampus.
Decreased hippocampal volume results when excessive stress alters the chemical
regulation in the brain, which harms the functionality of systems
such as learning and memory. The chemicals implicated in this structure mutation
include glutamate, GABA, norepinephrine, serotonin, and
cortisol. A host of other chemicals and structures are thought to play a role in
PTSD (Nutt, 2000).
Pathway Dysregulation - The dysregulation of GABA & glutamatergic pathways is
implicated in development and maintenance of PTSD. These two
amino acids (GABA, glutamate) work in tandem to translate experience and stimuli
into memory. Extreme stress can advesely affect these pathways,
eventually causing long-term synaptic changes that leads to abnormal, often
excessive, encoding of memory. In essence, memories can become deeply
ingrained when these pathways are overstimulated by stress. This mechanism helps
to explain the re-experiencing (e.g, flashbacks) symptoms of PTSD
(Nutt, 2000). These flashbacks serve as retraumatization, submitting the victim of
the intial trauma to repeated experiences that can be just as
distressing as the original (McFarlane, 2000).
Gender - Gender is an especially important and well researched risk factor for
PTSD. According to a recent study, men report having experienced
more traumatic events in their lives, but women have a higher prevelance of PTSD
(Perkonigg et al., 2000). A similar study found , indeed, that men
are exposed to more traumas throughout life, except for sexual violence, to which
women are more prone. This exception is significant, as sexual
traumas bring about PTSD at the highest rates (Kimerling et al., 2002).
Although men experience more traumas, women's subjective experience of trauma
is usually more threatening than that of men. Hence, trauma exposure
differences amongst genders is similar once subjective elements are considered. In
addition, not only are women twice as likely to develop PTSD in their lives
but the disorder's course in women tends to be more chronic. This chronicity is not
accounted for by the different nature of traumas that women experience.
Lastly, it is likely that male's risk for PTSD catches up with women's in setting that
are chronically affected by war or violence (Kimerling et al., 2002).
Family-related
A healthy family setting can provide a child with good protection from PTSD. In
family dynamics, the child can learn effective coping strategies,
develop self-confidence, and most importantly, establish a solid, loving support
system to protect them. Often learning through rolemodeling, a child of a divorced family may witness behaviors and thoughts that are
detrimental to their mental health (mistrust, blaming of others)
(Schiraldi, 2000).
Family History - A family history of anxiety can predispose an individual to PTSD,
which itself is an anxiety disorder (Durand, 2006).
Likewise, a family history of PTSD and trauma may predispose family members to
the disorder. Often, parents who have been trauma victims
will teach their children maladaptive methods of coping with these stressors.
These parents might also be emotionally unsupportive as a result of
their distressing experiences, leaving their children with a lack of support which
predisposes them to PTSD.
At-Trauma Factors
A traumatic event is more likely to adversly affect the victim if, in the initial period
following the event, he or she (1) dissociates, (2) believes that
they are responsible in some way or did not do all they could to remedy the situation
as it occured, and (3) feels alone or isolated. Each of these
conditions creates artificial separation from or unnecessary shame in regards to the
event (Schiraldi, 2000).
Severity of Trauma - With low-level stress or trauma, personal vulnerabilities weigh
more heavily in determining the development of PTSD (Durand, 2006)
Also, more severe traumas tend to lead to PTSD more often and result in more
chronic cases.
Proximity to Trauma - A person's proximity to a trauma has been found to be directly
related to their degree of resulting distress and PTSD
development. An interesting demonstration of this phenomenon was found in the
1987 study of children at an Los Angeles elementary school
who survived a sniper shooting at their playground. The closer the children were to
the playground (where the bullets were fired, some were killed,
and many were injured), the higher their reported stress reaction scores and incidence
and severity of PTSD were (Pynoos et al., 1987).
Type of Trauma - Trauma type interacts with various other factors (e.g., age, gender,
trauma severity) to reveal differing susceptibilities to PTSD
per type. See the bottom of this page for specific probabilities of PTSD associated
with certain traumas.
Post-Trauma Factors
Lack of social support - The most crucial protective factor from PTSD after a trauma
is the ability to rely on family, friends, and community to
prevent isolation and distract the victim from the traumatic memories. Often others
are unavailable because they too experienced the trauma or perhaps
because of their lack of connection with their own emotions. Seemingly supportive
individuals sometimes make the victim feel that they should "just get
over it" (Briere, 2004)
Blaming the Victim - For whatever reason, some victims of trauma (most notably rape
victims) are shamed or disbelieved in regard to the occurence of the
event. This rejection serves only to compound the distress of the victim. Another
prime example of this was the reception of Vietnam veterans after the war.
On top of the "shell shock" they were struggling with, the soldiers had to deal with a
public disapproving of the war for which they sacrificed (Schiraldi, 2000).
Secondary Victimization - This occurs when those who are supposed to help victims
in the posttraumatic period actually worsen the stress by subtly blaming
the victim. An example is when police officers might ask a rape victim if she
thinks the crime could have been prevented had she worn less revealing clothes
(Schiraldi, 2000).
Lack of Treatment - Whether intentional or ignorant, not seeking treatment further
isolates the victim and allows PTSD to progress chronically. The most effective,
empircally-based treatment is currently Cognitive Behavioral therapy, specifically
exposure therapy. Progressively and safely reexposing the victim to aspects of the
trauma can associate new, positive memories with the event (Schiraldi, 2000).
Current research estimates that only 38% of PTSD sufferers are undergoing treatment
during a given year. The most popular reason for not seeking treatment was that
they did not think they had a problem. This treatment rate, however, is comprable to
or higher than the same rates of treatment for depression and anxiety related
disorders (Kessler, 2000).
●Wohlfarth et al. are working to develop a reliable assessment tool that can identify
victims at high risk for PTSD. They are focusing not just on the risk factors involved, but
how predictive
each of these factors is in the subsequent onset of PTSD. They hope that this instrument
can be used to connect those at high risk for PTSD with treatment/psychoeducation
services soon
after the trauma.
Statistics
● Estimates of adults in the US that have experienced a traumatic event at least
once in their lives range from 40-90%
(depending on the definition of trauma), and up to 20% of these people go on to
develop PTSD (Perkonigg et al., 2000.
● An estimated 5% of Americans – more than 13 million people – have PTSD at any
given time.
● Approximately 8% of all adults – one of 13 people in this country – will develop
PTSD during their lifetime (DSM-IV-TR).
This qualifies PTSD as the most prevelant anxiety disorder in the general
population (Ballenger et al., 2000). These lifetime
prevelances vary greatly, from 1-30%, depending on the trauma type and
exposure (Wilson & Keane, 2004).
● An estimated one out of 10 women will get PTSD at some time in their lives.
Women are about twice as likely as men to develop PTSD.
This may be due to the fact that women tend to experience interpersonal violence
(such as domestic violence or rape) more often than men.
● Almost 13% of men and 10% of women have experienced more than three
traumatic events in their lives (Kessler et al., 1995).
● The estimated risk for developing PTSD for people who have experienced the
following traumatic events is:
→Rape (49%)
→Physical Assault (32%)
→Other sexual assault (24%)
→Serious accident or injuiry (17%)
→Shooting/Stabbing (15%)
→Unexpected death of relative/friend (14%)
→Child's life-threatening illness (10%)
→Witness killing/serious injury (7%)
→Natural disaster (4%)
(Perkonigg et al., 2000, Kessler et al., 1995, Ballenger et al., 2000)
DESCRIPTION
Basic Overview
Associated Features
Diagnostic Criteria
Basic Overview
Trauma is the prerequisite to Posttraumatic Stress Disorder (PTSD). This trauma can be
of varying nature and intensity. Personal and
situational vulnerabilities mix with situational factors to produce this trauma. Many more
personal and trauma-related factors again determine
the probability of a trauma victim developing PTSD. A relatively small percentage
(absolute highest estimate is 25%) of people actually
develop PTSD after a trauma, but this percentage varies across trauma type, gender, and
many other variables. It is crucial to further
elucidate all the relationships in this causal pathway to aid with prevention and treatment
of this debilitating disorder.
The three prominent symptoms of PTSD are heightened arousal, reexperiencing of the
traumatic event, and avoidance or emotional numbing.
These symptoms must cause significant distress or impairment to the individual for a
period of no less than one month. A similar combination
of symptoms that are experienced for less than 1 month is diagnosed as Acute Stress
Disorder.
The alarm reaction, arousal, in PTSD is similar to that of panic disorder (Panic Attacks).
However, the initial alarm in PTSD is accurate
(trauma is present), but subsequent alarms are not (trauma absent). If the alarm is strong
enough, it can become a conditioned response
to stimuli that triggers it.
Rexperiencing of traumatic event(s) takes place in a number of ways. Most commonly,
individuals experience intrusive 'flashbacks" in
which they truly feel that the event is recurring and they experience similar physical and
psychological reactions to this recurrence. It is
important to note that these flashbacks can propogate the distress of PTSD by keeping the
trauma current in the victim's mind.
The avoidance and emotional numbing that accompanies PTSD is often the factor that
induces the most social isolation and occupational
impairment. Thoughts and feelings associated with the trauma are avoided. Emotional
detachment follows in the progression, and can be
accompanied by memory loss and hopelessness.
PTSD is become an increasingly treatable disorder as the popular cognitive-behavioral
therapies advance. Further education is needed to
support prevention and treatment in those that are vulnerable.
Associated Features:
(1) Self-recrimination
(2) Shattered assumptions
(3) Mood disturbances
-Depression
-Anxiety
-Anger
-Grief
(4) Addictions
(5) Impulsivity
(6) Physical complaints
(7) Overcompensations
(8) Death anxiety
(9) Repitition compulsion
(10) Self-mutilation
(11) Alexithymia
This refers to the absence of feeling that can accompany PTSD.
(12) Personality changes
(Schiraldi, 2000)
"The aim of treating PTSD is to enable patients to live in the present with
freedom from feelings or behaviors that belong in the past." ~David J. Nutt
Typical Course:
Horowitz proposed a typical course that PTSD runs from traumatic stress reaction
to recovery.
(1) Outcry - This initial stage is the most emotionally intense, involving distressing
emotions that often become overwhelming.
The initial shock of the trauma characterizes this stage. The strong emotions might
begin to have a healing effect here.
(2) Avoidance/Denial - This stage involves withdrawal and emotional numbing. The
victim does not want to believe that the trauma
occured and compulsively tries to reassimilate with their pre-trauma existence.
Feeling flat, the victim often turns to drugs for relief.
(3) Intrusions - Intense emotions and thoughts that are reminiscent of the trauma begin to
creep back into consciousness, as indicated by the
person's heightened arousal. Reexperiencing also occurs in this phase. The arousal
tends to fluctuate as the victim struggles to accept
their plight.
(4) Work to Completion - This phase involves an emotional and cognitive reintegration
with reality. Acceptance of the trauma and its
consequences build and equilibrium is restored.
All too often, victims get stuck in a stage, leading to a chronic experience of PTSD. In
this case, treatment is especially beneficial (Schiraldi, 2000).
Prognosis:
Outcome is most promising when certain conditions are experienced:
● Less severe trauma
● Early intervention
● Strong social support
● Trauma not experienced up close
● Trauma had relative short duration, minimal recurrence
● No personal/family history of PTSD or associated disorders
● Victim is male
The prognosis is best defined by the associated risk factors for PTSD.
Click a topic to explore:
Prevelance
Comorbidity
As defined by DSM-IV-TR criteria, a traumatic event is necessary for the diagnosis of
PTSD (DSM-IV-TR, 2000).
One study reports that 40% of Americans have experienced at least one major trauma in
their lifetimes and that 8-12%
of Americans will suffer from PTSD at some point (Breslau et al., 1991). That means
that approxiamately one-quarter of
those who experience a severe trauma will subsequently develop PTSD. The National
Comorbidity Survery (NCS),
a more comprehensive study, found that 56% of Americans experience a lifetime trauma
while only 8% develop PTSD
(Perkonigg et al., 2000). Futhermore, many other studies have found variable rates of
trauma and PTSD in the population,
likely due to the variation among defining criteria. The prevailing message of these
studies is that although PTSD only
manifests in a portion of trauma victims, its overall prevelance is great enough to warrant
significant attention.
Prevelance
Epidemiologists study the patterns of illness in a population, and two major
epidemiological studies have shed some light on PTSD's prevelance.
The National Vietnam Veterans Readjustment Survey (NVVRS), conducted between
November 1986 and February 1988, comprised interviews
of 3,016 American veterans selected to provide a representative sample of those who
served in the armed forces during the Vietnam era. The National
Comorbidity Survey (NCS), conducted between September 1990 and February 1992,
comprised interviews of a representative national sample of 8,098
Americans aged 15-54 years (Kessler, 1995).
The NCS Report provided the following information about PTSD in the general
adult population:
The estimated lifetime prevalence of PTSD among adult Americans is 7.8%, with women
(10.4%) twice as likely as men (5%) to have PTSD at some point
in their lives. This represents a small portion of those who have experienced at least one
traumatic event; 60.7% of men and 51.2% of women reported at least
one traumatic event. The most frequently experienced traumas were:




Witnessing someone being badly injured or killed
Being involved in a fire, flood, or natural disaster
Being involved in a life-threatening accident
Combat exposure
The majority of the people in the NCS experienced two or more types of trauma. More
than 10% of men and 6% of women reported four or more types of
trauma during their lifetimes.
The traumatic events most often associated with PTSD in men were rape, combat
exposure, childhood neglect, and childhood physical abuse. For women,
the most common events were rape, sexual molestation, physical attack, being threatened
with a weapon, and childhood physical abuse.
However, none of these events invariably produced PTSD in those exposed to it, and a
particular type of traumatic event did not necessarily affect different portions
of the population in the same way.
The NCS report concluded that "PTSD is a highly prevalent lifetime disorder that often
persists for years."
The NVVRS report provided the following information about PTSD among
Vietnam War veterans:
The estimated lifetime prevalence of PTSD among American Vietnam theater veterans is
30.9% for men and 26.9% for women. Thus, more than half of all male
Vietnam veterans and almost half of all female Vietnam veterans -vabout 1,700,000
Vietnam veterans in all - have experienced "clinically serious stress reaction symptoms."
15% of all male Vietnam veterans and 8% of all female Vietnam veterans are currently
diagnosed with PTSD.
Comorbidity
PTSD is especially comorbid with Depressive, Anxiety, and Substance Disorders.
This page is meant to serve as a source of info
about Posttraumatic Stress Disorder, or PTSD.
A debilitating disease affecting people of any age,
PTSD develops after a significant traumatic event
has occurred in someone’s life. This stressor
can range from the unexpected death of a close
relative, to sexual assault, to encountering a
catastrophe first-hand.
Common symptoms include increased arousal, reexperiencing of the event (flashbacks), and
avoidance of reminders of the event.
Current research estimates that about 1 in 10
people will suffer from PTSD during their lifetime. Women are twice as likely to develop the
disorder. Given this prevalence, hopefully
this website can help provide resources for
prevention and links for effective treatments.