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post-traumatic stress disorder symptoms

Post-traumatic stress disorder (PTSD) has only existed as a diagnosis since 1980 (American Psychiatric Association 1980), and since 1992, using the International Classification of Diseases. However, the psychological and social effects of being exposed to a traumatic event have been recognized throughout history with ‘shell shock’, ‘traumatic neurosis’ and rape trauma syndrome being earlier means of describing the individual effects of specific traumas. Not everyone who is exposed to a trauma develops PTSD.

However, the previous belief that the response was a reaction to a ‘rare event’ has been dismissed as US research shows that 75 per cent of the general population have been exposed to a traumatic event which is significant enough to cause PTSD. While Breslau et al., in a US prevalence study in Detroit of 2181 people showed that 89.6 per cent of respondents had been exposed to an event once in their life which met DSM-IV criteria for the stressful traumatic event. However, only 25 per cent of these people will develop PTSD, and it is estimated that 12.5 per cent will continue to have PTSD for decades afterwards. Approximately 1 per cent of the general population will have PTSD at any one time.

However, prevalence varies following trauma according to the trauma type: 22–50 per cent of combat veterans; 75 per cent of shipwreck survivors; 50 per cent of bomb survivors; 37 per cent of hijack survivors; 22 per cent of air-crash survivors; 49 per cent of rape survivors; 21 per cent of survivors of assaultative violence; 24 per cent for sexual assault other than rape; and 10 per cent following a child’s life-threatening illness. The reason why traumas affect some people more than others has not been fully explained. Certain factors are known to affect a person’s response. These include: previous unresolved traumatic experiences, the traumatizing event, what happened to the person after the trauma experience (short term and long term), the amount of stress in the person’s life at the time of the trauma, and gender of trauma victim. In the Detroit study by Breslau et al., results suggested that when all factors were controlled for, that sex was a significant risk factor for developing PTSD, with the rate for women being two-fold higher than men.

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