Trauma & Stressor-Related Disorders
Understanding PTSD, acute stress, adjustment disorders, and trauma-informed care
Post-Traumatic Stress Disorder (PTSD)
Overview
PTSD is a condition characterized by intrusive thoughts, avoidant behaviors, persistent negative mood, and/or changes in arousal and reactivity that develop at least 1 month after exposure to a traumatic event. These symptoms cause significant distress or impairment.
Background Information
Description
PTSD is a condition characterized by intrusive thoughts, avoidant behaviors, persistent negative mood, and/or changes in arousal and reactivity that develop at least 1 month after exposure to a traumatic event, causing significant distress or impairment.
Types
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR) specifies two subtypes:
- PTSD with Dissociative Symptoms: Patients meet full criteria for PTSD and also experience persistent or recurrent symptoms of either depersonalization (feeling detached from oneself) or derealization (experiencing the world as unreal or dreamlike).
- PTSD with Delayed Expression: Patients do not meet full diagnostic criteria until at least 6 months after the traumatic event, although some symptoms may appear immediately.
Epidemiology
Incidence/Prevalence
- The lifetime prevalence of PTSD in the U.S. adult population is 6.1%, with higher rates in women (8%) than men (4.1%).
- Delayed-onset PTSD has a mean prevalence of 15% in civilians and 38% in military cases.
- Prevalence is higher among active-duty military members (estimated 10.4%) and veterans (6.9% lifetime).
- In perinatal and postpartum periods, PTSD prevalence is about 9% after childbirth, increasing to 15-25% after perinatal loss or preterm birth.
- Among children and adolescents, prevalence can be as high as 20-21% after traumatic events.
Risk Factors
While about half of adults experience a traumatic event, less than 10% develop PTSD. The likelihood increases with:
- History of prior traumatic exposures or other mental health conditions.
- Poor psychosocial support or coping skills.
- Ongoing stressors in the post-traumatic period.
- Higher rates are reported among Black, Latino, and Native American persons.
- Perceived discrimination can be a source of posttraumatic stress.
- Studies show a higher risk for women compared to men in White, African American, and Afro-Caribbean populations.
Associated Conditions
Over 50% of individuals with PTSD have comorbid psychiatric conditions, including:
- Anxiety and related disorders
- Substance use disorders
- Depression (reported in 57% of adults with PTSD)
- Suicidality and suicide attempts
PTSD is also associated with physical health conditions such as sleep disorders, respiratory conditions, osteoporosis, migraines, cardiovascular disease, and autoimmune diseases.