Post-traumatic stress disorder

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Post-traumatic stress disorder
immunological disorders [2]
Duration> 1 month[a]
CausesExposure to a traumatic event[1]
Diagnostic methodBased on symptoms[2]
TreatmentCounseling, medication,[4] MDMA-assisted psychotherapy,[5] selective serotonin reuptake inhibitors[6]
Frequency8.7% (lifetime risk); 3.5% (12-month risk) (US)[7]

Post-traumatic stress disorder (PTSD)

dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response.[1][4][10] These symptoms last for more than a month after the event.[1] Young children are less likely to show distress, but instead may express their memories through play.[1] A person with PTSD is at a higher risk of suicide and intentional self-harm.[2][11]

Most people who experience traumatic events do not develop PTSD.

natural disasters.[12][13][14] Those who experience prolonged trauma, such as slavery, concentration camps, or chronic domestic abuse, may develop complex post-traumatic stress disorder (C-PTSD). C-PTSD is similar to PTSD, but has a distinct effect on a person's emotional regulation and core identity.[15]

Prevention may be possible when

SNRI type are the first-line medications used for PTSD and are moderately beneficial for about half of people.[6] Benefits from medication are less than those seen with counselling.[2] It is not known whether using medications and counselling together has greater benefit than either method separately.[2][17] Medications, other than some SSRIs or SNRIs, do not have enough evidence to support their use and, in the case of benzodiazepines, may worsen outcomes.[18][19]

In the United States, about 3.5% of adults have PTSD in a given year, and 9% of people develop it at some point in their life.

armed conflict.[2] It is more common in women than men.[4]

Symptoms of trauma-related mental disorders have been documented since at least the time of the

military veterans of the Vietnam War.[24] It was officially recognized by the American Psychiatric Association in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).[25]

Symptoms

Service members use art to relieve PTSD symptoms.

Symptoms of PTSD generally begin within the first three months after the inciting traumatic event, but may not begin until years later.

acute stress disorder).[1][29][30][31] Some following a traumatic event experience post-traumatic growth.[32]

Associated medical conditions

Trauma survivors often develop depression, anxiety disorders, and mood disorders in addition to PTSD.

comorbid with PTSD. Resolving these problems can bring about improvement in an individual's mental health status and anxiety levels.[36][37]

PTSD has a strong association with tinnitus,[38] and can even possibly be the tinnitus' cause.[39]

In children and adolescents, there is a strong association between emotional regulation difficulties (e.g. mood swings, anger outbursts, temper tantrums) and post-traumatic stress symptoms, independent of age, gender, or type of trauma.[40]

Moral injury the feeling of moral distress such as a shame or guilt following a moral transgression is associated with PTSD but is distinguished from it. Moral injury is associated with shame and guilt, while PTSD is associated with anxiety and fear.[41]: 2,8,11 

In a population based study examining veterans of the

ischemic heart disease or cancers of the respiratory tract including lung cancer.[34][42]

Risk factors

No quieren (They do not want to) by Francisco Goya (1746–1828) depicts an elderly woman wielding a knife in defense of a girl being assaulted by a soldier.[43][unreliable source?]

Persons considered at risk for developing PTSD include combat military personnel, survivors of natural disasters, concentration camp survivors, and survivors of violent crime. Persons employed in occupations that expose them to violence (such as soldiers) or disasters (such as emergency service workers) are also at risk.[44] Other occupations at an increased risk include police officers, firefighters, ambulance personnel, health care professionals, train drivers, divers, journalists, and sailors, as well as people who work at banks, post offices or in stores.[45] The intensity of the traumatic event is also associated with a subsequent risk of developing PTSD, with experiences related to witnessed death, or witnessed or experienced torture, injury, bodily disfigurement, traumatic brain injury being highly associated with the development of PTSD. Similarly, experiences that are unexpected or in which the victim cannot escape are also associated with a high risk of developing PTSD.[34]

Trauma

PTSD has been associated with a wide range of traumatic events. The risk of developing PTSD after a traumatic event varies by trauma type[46][47] and is the highest following exposure to sexual violence (11.4%), particularly rape (19.0%).[48] Men are more likely to experience a traumatic event (of any type), but women are more likely to experience the kind of high-impact traumatic event that can lead to PTSD, such as interpersonal violence and sexual assault.[49]

Motor vehicle collision survivors, both children and adults, are at an increased risk of PTSD.[50][51] Globally, about 2.6% of adults are diagnosed with PTSD following a non-life-threatening traffic accident, and a similar proportion of children develop PTSD.[48] Risk of PTSD almost doubles to 4.6% for life-threatening auto accidents.[48] Females were more likely to be diagnosed with PTSD following a road traffic accident, whether the accident occurred during childhood or adulthood.[50][51]

Post-traumatic stress reactions have been studied in children and adolescents.[52] The rate of PTSD might be lower in children than adults, but in the absence of therapy, symptoms may continue for decades.[53] One estimate suggests that the proportion of children and adolescents having PTSD in a non-wartorn population in a developed country may be 1% compared to 1.5% to 3% of adults.[53] On average, 16% of children exposed to a traumatic event develop PTSD, with the incidence varying according to type of exposure and gender.[54] Similar to the adult population, risk factors for PTSD in children include: female gender, exposure to disasters (natural or man-made), negative coping behaviors, and/or lacking proper social support systems.[55]

Predictor models have consistently found that childhood trauma, chronic adversity, neurobiological differences, and familial stressors are associated with risk for PTSD after a traumatic event in adulthood.[56][57][58] It has been difficult to find consistently aspects of the events that predict, but peritraumatic dissociation has been a fairly consistent predictive indicator of the development of PTSD.[59] Proximity to, duration of, and severity of the trauma make an impact. It has been speculated that interpersonal traumas cause more problems than impersonal ones,[60] but this is controversial.[61] The risk of developing PTSD is increased in individuals who are exposed to physical abuse, physical assault, or kidnapping.[62][63] Women who experience physical violence are more likely to develop PTSD than men.[62]

Intimate partner violence

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