Post-traumatic stress disorder (PTSD) is a condition marked by increased stress and anxiety following a traumatic or stressful event. A diagnosis of PTSD can apply to adults, adolescents, and children. A person can be diagnosed with PTSD if exposed to actual or threatened death, serious injury, or sexual violence in one or more of the following ways:

• Directly experiencing the traumatic event(s).
• Witnessing, in person, the event(s) occur to others.
• Learning that a violent or accidental traumatic event(s) occurred to a close family member or close friend.
• Experiencing repeated or extreme exposure to adverse details of the traumatic event (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).
• Duration of symptoms more than 1 month

Epidemiology of PTSD

• About 8 percent of the general population is estimated to have PTSD. An additional 5 to 15 percent may experience partial symptoms of PTSD.
• The lifetime incidence of PTSD is estimated to be 9 to 15 percent. In women, the lifetime prevalence rate is 10 percent, versus 4 percent in men.
• An estimated 30 percent of men develop full-blown PTSD after serving in war, and an additional 22.5 percent develop most symptoms of PTSD.

Symptoms of PTSD

• A diagnosis of PTSD requires the presence of one or more of the following symptoms for more than 1 month:
• Recurrent, involuntary and intrusive distressing memories of the traumatic event(s).
• Recurrent distressing dreams related to the traumatic event(s).
• Flashbacks in which the individual feels or acts as if the traumatic event(s) is recurring. (Children may reenact trauma-specific events).
• Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
• Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

In addition, a diagnosis of PTSD requires that the affected individual demonstrates the following traits for more than 1 month:

• Avoidance of distressing memories, thoughts or feelings closely associated with the traumatic event(s).
• Avoidance of people, places, objects and situations that arouse distressing memories, thoughts or feelings closely associated with the traumatic event(s).
• Negative thoughts and mood associated with the traumatic event(s), beginning or worsening after the event(s), as evidenced by two or more of the following:
  • Inability to remember an important aspect of the traumatic event(s).
  • Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I’m a bad person,” “No one can be trusted,” The world is completely dangerous,” “My whole nervous system is permanently ruined”).
  • Persistent, distorted thoughts about the cause of consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
  • A persistent negative emotional state, such as fear, horror, anger, guilt or shame.
  • Markedly diminished interest or participation in significant activities.
  • Feelings of detachment or estrangement from others.
  • Persistent inability to experience positive emotions, such as happiness, satisfaction or loving feelings.
• Marked changes in behavior beginning or worsening after the traumatic event(s), as evidenced by two or more of the following:
  • Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
  • Reckless or self-destructive behavior.
  • Hypervigilance.
  • Exaggerated startle response.
  • Problems with concentration.
  • Sleep disturbance, such as restlessness or difficulty falling/staying asleep.