Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that may develop after exposure to a terrifying event or ordeal in which severe physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or unnatural disasters, accidents, or military combat.

Anyone who has gone through a life-threatening event can develop PTSD including military troops who served in wars; rescue workers for catastrophes like the 2001 terrorist attacks on New York City and Washington, D.C.; survivors of the Oklahoma City bombing; survivors of accidents, rape, physical or sexual abuse, and other crimes; immigrants fleeing violence in their countries; survivors of earthquakes, floods, and hurricanes; and those who witness traumatic events. Family members of victims can develop the disorder as well.

PTSD affects about 7.7 million American adults, but it can occur at any age, including childhood. Women are more likely to develop the disorder than men, and there is some evidence that it may run in families. PTSD is frequently accompanied by depression, substance abuse, or anxiety disorders. When other conditions are appropriately diagnosed and treated, the likelihood of successful treatment increases.

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Roughly 30 percent of Vietnam veterans developed PTSD. The disorder also has been detected in as many as 10% of Gulf War (Desert Storm) veterans, about 6% to 11% of veterans of the Afghanistan war, and about 12% to 20% of veterans of the Iraq war.

Other factors in a combat situation can add more stress to an already stressful situation and may contribute to PTSD and other mental health problems. These factors include what you do in the war, the politics around the war, where it's fought, and the type of enemy you face.
Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to men and women and can occur during peacetime, training, or war. Among veterans using VA health care, about 23 out of 100 women (23%) reported sexual assault when in the military, 55 out of 100 women (55%) and 38 out of 100 men (38%) have experienced sexual harassment when in the military.

PTSD is diagnosed when the stress symptoms following exposure have persisted for at least a month. When symptoms develop immediately after exposure, the condition may be called acute stress disorder.

Complex PTSD

Complex PTSD, also known as disorder of extreme stress, is found among individuals who have been exposed to prolonged traumatic circumstances, especially during childhood, such as childhood sexual abuse. Research shows that many brain and hormonal changes may occur as a result of early, prolonged trauma, and contribute to troubles with learning, memory, and regulating emotions. Combined with a disruptive, abusive home environment, these brain and hormonal changes may contribute to severe behavioral difficulties such as eating disorders, impulsivity, aggression, inappropriate sexual behavior, alcohol or drug abuse, and other self-destructive actions, as well as emotional regulation (such as intense rage, depression, or panic) and mental difficulties (such as scattered thoughts, dissociation, and amnesia). As adults, these individuals often are diagnosed with depressive disorders, personality disorders, or dissociative disorders. Treatment may progress at a much slower rate, and requires a sensitive and structured program delivered by a trauma specialist.

Post-Traumatic Stress Disorder. Last reviewed 06/19/2010

Sources:

  • American Journal of Psychiatry
  • Journal of Psychopharmacology
  • Journal of Traumatic Stress
  • National Comorbidity Survey Replication
  • Biological Psychiatry
  • Annual Review of Psychology
  • National Institutes of Health - National Library of Medicine
  • National Institute of Mental Health
  • US Department of Health and Human Services
  • Hippocampal Volume in Women Victimized by Childhood Sexual Abuse.
  • National Center for PTSD, U.S. Department of Veterans Affairs
  • Canadian Journal of Psychiatry
  • Psychiatric Clinics of North America