Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Posttraumatic stress disorder (PTSD) is an emotional illness that that is classified as an anxiety disorder and usually
develops as a result of a terribly frightening, life-threatening, or otherwise
highly unsafe experience. PTSD sufferers re-experience the traumatic event or
events in some way, tend to avoid places, people, or other things that remind
them of the event (avoidance), and are exquisitely sensitive to normal life
experiences (hyperarousal). Although this condition has likely existed since
human beings have endured trauma, PTSD has only been recognized as a formal
diagnosis since 1980. However, it was called by different names as early as the
American Civil War, when combat veterans were referred to as suffering from
"soldier's heart." In World War I, symptoms that were generally consistent with
this syndrome were referred to as "combat fatigue." Soldiers who developed such
symptoms in World War II were said to be suffering from "gross stress reaction,"
and many troops in Vietnam who had symptoms of what is now called PTSD were
assessed as having "post-Vietnam syndrome." PTSD has also been called "battle
fatigue" and "shell shock."
Complex posttraumatic stress disorder (C-PTSD)
usually results from prolonged exposure to a traumatic event or series thereof
and is characterized by long-lasting problems with many aspects of emotional and
social functioning.
Statistics regarding this illness indicate that
approximately 7%-8% of people in the United States will likely develop PTSD in
their lifetime, with the lifetime occurrence (prevalence) in combat veterans and
rape victims ranging from 10% to as high as 30%. Somewhat higher rates of this
disorder have been found to occur in African Americans, Hispanics, and Native
Americans compared to Caucasians in the United States. Some of that difference
is thought to be due to higher rates of dissociation soon before and after the
traumatic event (peritraumatic), a tendency for individuals from minority ethnic
groups to blame themselves, have less social support, and an increased
perception of racism for those ethnic groups, as well as differences between how
ethnic groups may express distress. In military populations, many of the
differences have been found to be the result of increased exposure to combat at
younger ages for minority groups. Other important facts about PTSD
include the estimate of 5 million people who suffer from PTSD at any one time in
the United States and the fact that women are twice as likely as men to develop
PTSD.
Almost half of individuals who use outpatient mental-health services
have been found to suffer from PTSD. As evidenced by the occurrence of stress in
many individuals in the United States in the days following the 2001 terrorist
attacks, not being physically present at a traumatic event does not guarantee
that one cannot suffer from traumatic stress that can lead to the development of
PTSD.
PTSD statistics in children and teens reveal that up to more than 40%
have endured at least one traumatic event, resulting in the development of PTSD
in up to 15% of girls and 6% of boys. On average, 3%-6% of high school students
in the United States and as many as 30%-60% of children who have survived
specific disasters have PTSD. Up to 100% of children who have seen a parent
killed or endured sexual assault or abuse tend to develop PTSD, and more than
one-third of youths who are exposed to community violence (for example, a shooting,
stabbing, or other assault) will suffer from the disorder.
Virtually any trauma, defined as an event that is life-threatening or that severely compromises the emotional well-being of an individual or causes intense fear, may cause PTSD. Such events often include either experiencing or witnessing a severe accident or physical injury, receiving a life-threatening medical diagnosis, being the victim of kidnapping or torture, exposure to war combat or to a natural disaster, exposure to other disaster (for example, plane crash) or terrorist attack, being the victim of rape, mugging, robbery, or assault, enduring physical, sexual, emotional, or other forms of abuse, as well as involvement in civil conflict. Although the diagnosis of PTSD currently requires that the sufferer has a history of experiencing a traumatic event as defined here, people may develop PTSD in reaction to events that may not qualify as traumatic but can be devastating life events like divorce or unemployment.
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