- Posttraumatic Stress Disorder (PTSD) Center
- Take the PTSD Quiz!
- Stress-Reducing Foods Slideshow
- Take the Panic Attacks Quiz!
- Posttraumatic Stress Disorder (PTSD) FAQs
- Patient Comments: Posttraumatic Stress Disorder - Effective Treatments
- Patient Comments: Posttraumatic Stress Disorder - Symptoms
- Patient Comments: Posttraumatic Stress Disorder - Causes
- Patient Comments: Posttraumatic Stress Disorder - Coping
- Find a local Psychiatrist in your town
- PTSD facts
- What is posttraumatic stress disorder (PTSD)?
- What are the effects of PTSD?
- What causes PTSD?
- What are PTSD risk factors and protective factors?
- What are PTSD symptoms and signs?
- How is PTSD assessed?
- What is the treatment for PTSD?
- What is the prognosis for PTSD?
- Is it possible to prevent PTSD?
- How can people cope with PTSD?
- Where can people get help for PTSD?
- Posttraumatic stress disorder (PTSD) is an emotional illness that was first formally diagnosed in soldiers and war veterans and is usually caused by terribly frightening, life-threatening, or otherwise highly unsafe experiences but can also be caused by devastating life events like unemployment or divorce.
- PTSD symptom types include re-experiencing the trauma, avoidance, emotional numbing, and hyperarousal.
- PTSD affects 8 million adults in any one year. Girls, women, and ethnic minorities develop PTSD more than boys, men, and Caucasians.
- Complex posttraumatic stress disorder (C-PTSD) usually results from prolonged exposure to traumatic event(s) and is characterized by long-lasting problems that affect many aspects of emotional and social functioning.
- Symptoms of C-PTSD include problems regulating feelings, dissociation, or depersonalization, persistent depressive feelings, seeing the perpetrator of trauma as all powerful, preoccupation with the perpetrator, and a severe change in what gives the sufferer meaning.
- Untreated PTSD can have devastating, far-reaching consequences for sufferers' medical, emotional, and vocational functioning and relationships, their families, and for society. Children with PTSD can experience significantly negative effects on their social and emotional development, as well as their ability to learn.
- Although almost any event that is life threatening or that severely compromises the emotional well-being of an individual may cause PTSD, such events usually include experiencing or witnessing a severe accident or physical injury, getting a frightening medical diagnosis, being the victim of a crime or torture, exposure to combat, disaster, or terrorist attack, enduring any form of abuse, or involvement in civil conflict.
- Issues that tend to put people at higher risk for developing PTSD include female gender, minority status, increased duration or severity of, as well as exposure to, the trauma experienced, having an emotional condition prior to the event, and having little social support. Risk factors for children and adolescents also include having any learning disability or experiencing violence in the home.
- Disaster preparedness training may be a protective factor for PTSD as can rapid intervention and certain personal, interpersonal, and environmental factors.
- Medicines that treat depression (for example, serotonergic antidepressants or SSRIs) or that decrease the heart rate (for example, propranolol) are thought to be effective tools in the prevention of PTSD when given in the days immediately after an individual experiences a traumatic event.
- SSRIs seem to be most effective in treating people whose PTSD is the result of noncombat-related trauma.
- Individuals who wonder if they may be suffering from PTSD may benefit from taking a self-test as they consider meeting with a health-care professional. Professionals may use a clinical interview in adults, children, or adolescents, or one of a number of structured tests with children or adolescents to assess for the presence of this illness.
- Diagnosing PTSD can present a challenge for professionals since sufferers often come for evaluation of something that seems to be unrelated to that illness at first. Those symptoms tend to be physical complaints, depression, or substance abuse. Also, PTSD often co-occurs with other anxiety disorders, manic depression, or with eating disorders.
- Challenges for the assessment of PTSD in children and adolescents include an adult caretakers' tendency to be unaware of the extent of the young person's symptoms and the tendency for children and teens to express symptoms of the illness in ways that are quite different from adults.
- Treatments for PTSD usually include psychological and medical treatments. Education about the illness, helping the individual talk about the trauma directly, exploration and modification of inaccurate ways of thinking about it, and teaching the person ways to manage symptoms and are the usual techniques used in psychotherapy. Family and couples' counseling, parenting classes, and education about conflict resolution are other useful psychotherapeutic interventions.
- Directly addressing the sleep problems that are associated with PTSD has been found to help alleviate those problems, thereby decreasing the symptoms of PTSD in general.
- Medications that are usually used to help PTSD sufferers include serotonergic antidepressants (SSRIs) and medicines that help decrease the physical symptoms associated with illness. Other potentially helpful medications for managing PTSD include mood stabilizers and antipsychotics. Tranquilizers have been associated with withdrawal symptoms and other problems and have not been found to be significantly effective for helping individuals with PTSD.
- Some ways that are often suggested for PTSD patients to cope with this illness include learning more about the illness, occupational therapy including service dog therapy, talking to others for support, using relaxation techniques, participating in treatment, increasing positive lifestyle practices, and minimizing negative lifestyle practices.
What is posttraumatic stress disorder (PTSD)?
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 in the military 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 a low percentage of people in the United States will likely develop PTSD in their lifetime. Combat veterans and rape victims have a lifetime prevalence of PTSD. 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 those differences are 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 exposure to 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 8 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 will not suffer from traumatic stress that can lead to the development of PTSD.
PTSD statistics in children and teens reveal that up to 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. Most 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.
What are the effects of PTSD?
Although not all individuals who have been traumatized develop PTSD, there can be significant physical consequences of being traumatized. For example, research indicates that people who have been exposed to an extreme stressor sometimes have a smaller hippocampus (a region of the brain that plays a role in memory) than people who have not been exposed to trauma. This is significant in understanding the effects of trauma in general and the impact of PTSD, specifically since the hippocampus is the part of the brain that is thought to have an important role in developing new memories about life events. Also, whether or not a traumatized person goes on to develop PTSD, they seem to be at risk for higher use of cigarettes, alcohol, and marijuana. Conversely, people whose PTSD is treated also tend to have better success at overcoming a substance-abuse problem.
Untreated PTSD can have devastating, far-reaching consequences for sufferers' functioning and relationships, their families, and for society. Complications of PTSD in women who are pregnant include having other emotional problems, poor health behaviors, and memory problems. Women who were sexually abused at earlier ages are more likely to develop complex PTSD and borderline personality disorder. Babies who are born to mothers who suffer from this illness during pregnancy are more likely to experience a change in at least one chemical in their body that makes it more likely (predisposes) the baby to develop PTSD later in life. Individuals who suffer from this illness are at risk of having more medical problems, as well as trouble reproducing. Emotionally, PTSD sufferers may struggle more to achieve as good an outcome from mental-health treatment as that of people with other emotional problems. In children and teens, PTSD can have significantly negative effects on their social and emotional development, as well as on their ability to learn.
Economically, PTSD can have significant consequences as well. As of 2005, more than 200,000 veterans were receiving disability compensation for this illness, at a cost of $4.3 billion. This represents an 80% increase in the number of military people receiving disability benefits for PTSD and an increase of 149% in the amount of disability benefits paid compared to those numbers five years earlier.
What causes PTSD?
Virtually any trauma, defined as an event that is life-threatening or that severely compromises the physical or 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.
What are PTSD risk factors and protective factors?
Issues that tend to put people at higher risk for developing PTSD include increased duration of a traumatic event, higher number of traumatic events endured, higher severity of the trauma experienced, having an emotional condition prior to the event, or having little social support in the form of family or friends. In addition to those risk factors, children and adolescents, females, minority groups and people with learning disabilities or violence in the home seem to have a greater risk of developing PTSD after a traumatic event.
What are PTSD symptoms and signs?
The following three groups of symptom criteria are required to assign the diagnosis of PTSD in the context of an individual who has a history of being exposed to an actual or perceived threat of death, serious injury, or sexual violence to self or others that does not involve exposure through media unless that is work related:
- Recurrent re-experiencing of the trauma (for example, troublesome memories, flashbacks that are usually caused by reminders of the traumatic events, recurring nightmares about the trauma and/or dissociative reliving of the trauma): In children, this may include repetitive play about the trauma.
- Avoidance to the point of having a phobia of places, people, and experiences that remind the sufferer of the trauma, or a general numbing of emotional responsiveness
- Negative changes in thinking and trouble remembering important aspects of the trauma, holding negative beliefs about him or herself, a tendency to blame oneself for the trauma, a persistently negative emotional state, inability to have positive emotions, low interest or participation in significant activities, and feeling detached from others
- Significant changes in arousal and reactivity related to the traumatic event(s), including sleep problems, trouble concentrating, irritability, anger, poor concentration, blackouts or difficulty remembering things, reckless or self-destructive behavior, increased tendency and reaction to being startled, and hypervigilance (excessive watchfulness) to threat
The emotional numbing of PTSD may present as a lack of interest in activities that used to be enjoyed (anhedonia), emotional deadness, distancing oneself from people, and/or a sense of a foreshortened future (for example, not being able to think about the future or make future plans, not believing one will live much longer). At least one re-experiencing symptom, one avoidance symptom, two negative changes in mood or thinking, and two hyperarousal symptoms must be present for at least one month and must cause significant distress or impairment in functioning in order for the diagnosis of PTSD to be assigned.
A similar disorder in terms of symptom repertoire is acute stress disorder. The major differences between the two disorders are that acute stress disorder symptoms persist from three days to one month after the trauma exposure, and a fewer number of traumatic symptoms are required to make the diagnosis as compared to PTSD.
In children, re-experiencing the trauma may occur through repeated play that has trauma-related themes instead of or in addition to memories, and distressing dreams may have more general content rather than of the traumatic event itself. As in adults, at least one re-experiencing symptom, one avoidance/numbing symptom, and two hyperarousal symptoms must be present for at least one month and must cause significant distress or functional impairment in order for the diagnosis of PTSD to be assigned. When symptoms have been present for three days to one month, a diagnosis of acute stress disorder (ASD) can be made.
Symptoms of PTSD that tend to be associated with C-PTSD include problems regulating feelings, which can result in suicidal thoughts, explosive anger, or passive aggressive behaviors, a tendency to forget the trauma or feel detached from one's life (dissociation) or body (depersonalization), persistent feelings of helplessness, shame, guilt, or being completely different from others, feeling the perpetrator of trauma is all powerful, and preoccupation with either revenge against or allegiance with the perpetrator, and severe change in those things that give the sufferer meaning, like a loss of spiritual faith or an ongoing sense of helplessness, hopelessness, or despair.
How is PTSD assessed?
For individuals who may be wondering if they should seek evaluation for PTSD by their medical or mental-health professional, self-tests may be useful. The National Institute of Mental Health offers a self-test for PTSD. The assessment of PTSD can be difficult for practitioners to make since sufferers often come to the professional's office complaining of symptoms other than anxiety associated with a traumatic experience. Those symptoms tend to include body symptoms (somatization), depression, or drug addiction. Studies of Iraq war veterans indicate that these individuals tend to show more physical symptoms of PTSD as opposed to describing the associated emotional problems.
Individuals with PTSD may present with a history of making suicide attempts. In addition to depression and substance-use disorders, the diagnosis of PTSD often co-occurs (is comorbid) with bipolar disorder (manic depression), eating disorders, and other anxiety disorders like obsessive compulsive disorder (OCD), panic disorder, social anxiety disorder, and generalized anxiety disorder.
Most health-care professionals who examine a child or teenager for PTSD will interview both the parent and the child, usually separately, in order to allow each party to speak freely. Interviewing the child in addition to the adults in his or her life is quite important given that while the child or adolescent's parent or guardian may have a unique perspective, there are naturally things the young person may be thinking, feeling, or doing that the adult is not aware of. Another challenge for diagnosing PTSD in children, particularly in younger children, is that they may express their symptoms differently from adults. For example, symptoms in children may include the child going backward or regressing in their development, becoming accident prone, engaging in risky behaviors, becoming clingy, or suffering from more physical complaints as compared to adults with PTSD. Traumatized younger children may also have trouble sitting still, focusing, or managing their impulses and therefore be mistaken as suffering from attention deficit hyperactivity disorder (ADHD).
Sometimes, professionals will use a rating scale or a structured psychiatric interview for children in its entirety or just the portion that assesses PTSD in order to test for PTSD. Examples of such tools include the Diagnostic Interview for Children and Adolescents-Revised (DICA-R), the Diagnostic Interview Schedule for Children-Version IV (DISC-IV), and the Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS). There are also some PTSD-specific structured interviews, like the Clinician-Administered PTSD Scale-Child and Adolescent Version, the Child PTSD Checklist, and the Child PTSD Symptom Scale. For the assessment of the severity of PTSD symptoms in children, structured interviews like the Child Posttraumatic Stress Reaction Index, the Child and Adolescent Trauma Survey, and the Trauma Symptom Checklist for Children are sometimes used. The Child Trauma Screening Questionnaire has been found by some professionals to be useful in predicting which children who endure a traumatic event will go on to develop PTSD.
What is the treatment for PTSD?
Treatments for PTSD usually include psychological and medical interventions. Providing information about the illness, helping the individual manage the trauma by talking about it directly, teaching the person ways to manage symptoms of PTSD, and exploration and modification of inaccurate ways of thinking about the trauma are the usual techniques used in psychotherapy for this illness. Education of PTSD sufferers usually involves teaching individuals about what PTSD is, how many others suffer from the same illness, that it is caused by extraordinary stress rather than personal weakness, how it is treated, and what to expect in treatment. This education thereby increases the likelihood that inaccurate ideas the person may have about the illness are dispelled, and any shame they may feel about having it is minimized. This may be particularly important in populations like military personnel that may feel particularly stigmatized by the idea of seeing a mental-health professional and therefore avoid doing so.
Teaching people with PTSD practical approaches to coping with what can be very intense and disturbing symptoms has been found to be another useful way to treat the illness. Specifically, helping sufferers learn how to manage their anger and anxiety, improve their communication skills, and use breathing and other relaxation techniques can help individuals with PTSD gain a sense of mastery over their emotional and physical symptoms. The health-care professional might also use exposure-based cognitive behavioral therapy by having the person with PTSD recall their traumatic experiences using images or verbal recall while using the coping mechanisms they learned. Individual or group cognitive behavioral psychotherapy can help people with PTSD recognize and adjust trauma-related thoughts and beliefs by educating sufferers about the relationships between thoughts and feelings, exploring common negative thoughts held by traumatized individuals, developing alternative interpretations, and by practicing new ways of looking at things. This treatment also involves practicing learned techniques in real-life situations.
Eye-movement desensitization and reprocessing (EMDR) is a form of cognitive therapy in which the health-care professional guides the person with PTSD in talking about the trauma suffered and the negative feelings associated with the events, while focusing on the professional's rapidly moving finger. While some research indicates this treatment may be effective, it is unclear if this is any more effective than cognitive therapy that is done without the use of rapid eye movement.
Helping PTSD sufferers maintain their employment and other tasks of their daily lives is an important part of treatment. Occupational therapy (OT) is an important treatment modality in that regard, in that it focuses on rehabilitation and recovery through participation in activities. This can range from assisting helping people with PTSD regain independence in basic self-care to helping them reintegrate into previously held work and community roles. Another potentially powerfully positive activity-based intervention for individuals with PTSD can be the use of a service dog. Particularly toward the completion of more conventional treatments, service dogs have been found to be effective in improving PTSD suffers' sense of safety, responsibility, optimism, and self-awareness.
Families of PTSD individuals, as well as the sufferer, may benefit from family counseling, couples counseling, parenting classes, and conflict-resolution education. Family members may also be able to provide relevant history about their loved one (for example, about emotions and behaviors, drug abuse, sleeping habits, and socialization) that people with the illness are unable or unwilling to share.
Directly addressing the sleep problems that can be part of PTSD has been found to not only help alleviate those problems but to thereby help decrease the symptoms of PTSD in general. Specifically, rehearsing adaptive ways of coping with nightmares (imagery rehearsal therapy), training in relaxation techniques, positive self-talk, and screening for other sleep problems have been found to be particularly helpful in decreasing the sleep problems associated with PTSD.
Medications that are usually used to help PTSD sufferers include serotonergic antidepressants (SSRIs), like fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil), and medicines that help decrease the physical symptoms associated with illness, like prazosin (Minipress), clonidine (Catapres), guanfacine (Tenex), and propranolol. Individuals with PTSD are much less likely to experience a relapse of their illness if antidepressant treatment is continued for at least a year. SSRIs are the first group of medications that have received approval by the U.S. Food and Drug Administration (FDA) for the treatment of PTSD. Treatment guidelines provided by the American Psychiatric Association describe these medicines as being particularly helpful for people whose PTSD is the result of trauma that is not combat related. SSRIs tend to help PTSD sufferers modify information that is taken in from the environment (stimuli) and to decrease fear. Research also shows that this group of medicines tends to decrease anxiety, depression, and panic. SSRIs may also help reduce aggression, impulsivity, and suicidal thoughts that can be associated with this disorder. For combat-related PTSD, there is more and more evidence that prazosin can be particularly helpful. Although other medications like duloxetine (Cymbalta), bupropion (Wellbutrin), venlafaxine (Effexor), and desvenlafaxine (Pristiq) are sometimes used to treat PTSD, there is little research that has studied their effectiveness in treating this illness.
Other less directly effective but nevertheless potentially helpful medications for managing PTSD include mood stabilizers like lamotrigine (Lamictal), tiagabine (Gabitril), and divalproex sodium (Depakote), as well as mood stabilizers that are also antipsychotics, like risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), aripiprazole (Abilify), asenapine (Saphris), and paliperidone (Invega). Antipsychotic medicines seem to be most useful in the treatment of PTSD in those who suffer from agitation, dissociation, hypervigilance, intense suspiciousness (paranoia), or brief breaks in being in touch with reality (brief psychotic reactions). The antipsychotic medications are also being increasingly found to be helpful treatment options for managing PTSD when used in combination with an SSRI.
Benzodiazepines (tranquilizers) such as diazepam (Valium) and alprazolam (Xanax) have unfortunately been associated with a number of problems, including withdrawal symptoms, and risks of overdose and addiction, and have not been found to be significantly effective for helping individuals with PTSD.
What is the prognosis for PTSD?
A number of factors are thought to improve the prognosis (outlook) for people with PTSD. They include personal attributes like above-average cognitive abilities, high self-esteem and optimism, interpersonal abilities like good social skills, problem solving, and impulse control, and external factors like secure attachment, sense of safety, and environmental stability.
Is it possible to prevent PTSD?
While disaster-preparedness training is generally seen as a good idea in terms of improving the immediate physical safety and logistical issues involved with a traumatic event, such training may also provide important preventive factors against developing PTSD. That is as evidenced by the fact that those with more professional-level training and experience (for example, police, firefighters, mental-health professionals, paramedics, and other medical professionals) tend to develop PTSD less often when coping with disaster than those without the benefit of such training or experience. People who have been traumatized but are not members of those professions have been found to be less likely to develop PTSD if they receive imaging exposure and therapeutic processing by trained professionals within a day of the trauma and weekly sessions for at least two weeks thereafter.
There are medications that have been found to help prevent the development of PTSD. Some medicines that treat depression, decrease the heart rate, or increase the action of other body chemicals are thought to be effective tools in the prevention of PTSD when given in the days immediately after an individual experiences a traumatic event.
How can people cope with PTSD?
Some ways that are often suggested for PTSD patients to cope with this illness include learning more about the disorder as well as talking to friends, family, professionals, and PTSD survivors for support. Joining a support group may be helpful. Other tips include reducing stress by using relaxation techniques (for example, breathing exercises, positive imagery), actively participating in treatment as recommended by professionals, increasing positive lifestyle practices (for example, exercise, healthy eating, distracting oneself through keeping a healthy work schedule if employed, volunteering whether employed or not), and minimizing negative lifestyle practices like substance abuse, social isolation, working to excess, and self-destructive or suicidal behaviors.
Where can people get help for PTSD?
Air Force Palace HART
Email: [email protected]
American Love and Appreciation Fund (for veterans)
Army Wounded Warrior Program
Phone: 800-237-1336 or 800-833-6622
DHSD Deployment Helpline
Marine for Life
Email: [email protected]
Military One Source
Military Severely Injured Center
Email: [email protected]
National Coalition Against Sexual Assault
National Alliance for Mentally Ill
National Mental Health Association
Navy Safe Harbor
Email: [email protected]
Operation Comfort (for veterans and their families)
Phone: 866-632-7868 (1-866-NEAR TO U)
PTSD Information Hotline
Rape, Abuse and Incest National Network
As the use of the Internet continues to expand, so will Internet psychiatry. This is particularly true given that it may be quite useful in specifically providing access to psychotherapy for individuals with PTSD. Other areas that researchers are targeting to improve recovery for PTSD sufferers include expanding research on eye movement desensitization and reprocessing (EMDR), studying how PTSD can be more specifically treated in various ethnic groups, and discovering how to best prevent people from developing the illness. For military personnel, the more access to care that can be made available and the more comfortable active duty and veteran military men and women can be made to seek those services, the better the outcome that can be expected for service individuals with PTSD.
Daily Health News
Subscribe to MedicineNet's Depression Newsletter
Ahmed, A.S. "Post-traumatic stress disorder, resilience and vulnerability." Advances in Psychiatric Treatment 13 (2007): 369-375.
American Academy of Child and Adolescent Psychiatry. Child and adolescent mental health statistics Resources for Families, 2007.
American Psychiatric Association. Diagnostic Criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition, Treatment Revision, Washington, D.C., 2013.
Andreasen, N.C. "Acute and delayed posttraumatic stress disorders: a history and some issues." American Journal of Psychiatry 161 August 2004:1321-1323.
Autry, D. "VA to review 72,000 PTSD claims." Disabled American Veterans Magazine Nov.-Dec. 2005.
Beals, J., Novins, D.K., Whitesell, N.R., Spicer, P., Mitchell, C.M., Manson, S.M. "American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project Team. Prevalence of mental disorders and utilization of mental health Services in two American Indian reservation populations: mental health disparities in a national context." American Journal of Psychiatry 162 September 2005: 1723-1732.
Benedek, D.M., M.J. Friedman, D. Zatzick, and R.J. Ursano. "Guideline watch: Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder." Arlington, Virginia: American Psychiatric Association, 2009.
Bryant, R.A., Harvey, A.G. "Gender differences in the relationship between acute stress disorder and posttraumatic stress disorder following motor vehicle accidents." Australian and New Zealand Journal of Psychiatry 37.2 April 2003: 226-229.
Cahill, S.P. "Counterpoint: evaluating EMDR in treating PTSD." Psychiatric Times 17.7, July 2000.
Cohen, L.R., and D.A. Hien. Treatment outcomes for women with substance abuse and PTSD who have experienced complex trauma. Psychiatric Services 2006 January; 57: 100-106.
Davidson, J.R.T. "Effective Management Strategies for Posttraumatic Stress Disorder." Focus 1 (2003): 239-243.
Davidson, J.R.T. "Surviving disaster: what comes after the trauma?" The British Journal of Psychiatry 181 (2002): 366-368.
Davidson, J.R.T, Stein, D.J., Shalev, A.Y., Yehuda, R. "Posttraumatic stress disorder: acquisition, recognition, course and treatment." Journal of Neuropsychiatry 16 May 2004: 135-147.
Department of Mental Health and Developmental Disabilities. Initiatives promoting mental health, 2007.
Ferenc, M., Brown, E.B., Zhang, H., Koke, S.C., Prakash, A. "Fluoxetine v. placebo in prevention of relapse in post-traumatic stress disorder." The British Journal of Psychiatry 181 (2002): 315-320.
Friedman, M.J. "Acknowledging the psychiatric cost of war." New England Journal of Medicine 351.1 July 1, 2004: 75-77.
Friedman, M.J. "Posttraumatic stress disorder among military returnees from Afghanistan and Iraq." American Journal Psychiatry 163 April 2006: 586-593.
Giannopoulou, I., Dikaiakou, A., Yule, W. "Cognitive-behavioral group intervention for PTSD symptoms in children following the Athens 1999 earthquake: a pilot study." Clinical Child Psychology and Psychiatry 11.4 (2006): 543-553.
Holtzheimer, P.E., Russo, J., Zatzick, D., Bundy, C., Roy-Byrne, P.P. The impact of comorbid posttraumatic stress disorder on short-term clinical outcome in hospitalized patients with depression. American Journal of Psychiatry 162: 970-976, May 2005.
Kaminer, D., Seedat, S., Stein, D.J. Post-traumatic stress disorder in children. World Psychiatry 4(2): 121-125, June 2005.
Keane, T.M., Marshall, A.D., Taft, C.T. Posttraumatic stress disorder: etiology, epidemiology and treatment outcome. Annual Review of Clinical Psychology 2: 161-197, April 2006.
Kenardy, J.A., Spence, S.H., Macleod, A.C. Screening for posttraumatic stress disorder in children after accidental injury. Pediatrics 118: 1002-1009. 2006.
Knaevelsrud, C., Maercker, A. Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: a randomized controlled clinical trial. BioMed Central Psychiatry 7: 13, 4/19/07.
Lamarche, L.J., De Koninck, J. Sleep disturbance in adults with posttraumatic stress disorder: a review. Journal of Clinical Psychiatry 68(8): 1257-1270. August 2007.
Levin, A. "Early intervention offers hope for preventing PTSD." Psychiatric News 48.1 Jan. 2013: 21.
Levin, A. "Role of sociodemographics still unclear in PTSD." Psychiatric News 43.21 (2008): 17.
Loo, C.M. PTSD among ethnic minority veterans. National Center for PTSD, 2007.
Lorber, J. "For the battle-scarred, comfort at leash's end." The New York Times, 2010.
McLean, L.M., Gallop, R. Implications of childhood sexual abuse for adult borderline personality disorder and complex posttraumatic stress disorder. American Journal of Psychiatry 160: 369-371, April 2003.
Meiser-Stedman, R., Smith, P., Glucksman, W.Y., Dalgleish, T. parent and child agreement for acute stress disorder, post-traumatic stress disorder and other psychopathology in a prospective study of children and adolescents exposed to single-event trauma. Journal of Abnormal Child Psychology 35(2): 191-201. April 2007.
Mental Health News. Prevalence and Correlates of Post Traumatic Stress Disorder and Chronic Severe Pain in Psychiatric Outpatients. June 1, 2007.
Mol, S.S.L., Arntz, A., Metsemakers, J.F.M., et al. "Symptoms of post-traumatic stress disorder after non-traumatic events: evidence from an open population study." The British Journal of Psychiatry 186 (2005): 494-499.
NARSAD. Post-traumatic stress disorder can damage children's brain development. www.narsad.org, 11/20/07.
NIMH. Post traumatic stress disorder: a real illness. www.nimh.nih.gov, 11/19/07.
Perilla, J.L., Norris, F.H., Lavizzo. Ethnicity, culture and disaster response: identifying and explaining ethnic differences in PTSD six months after hurricane Andrew. Journal of Social and Clinical Psychology 21(1): 20-45, March 2002.
Perrin, M.A., DiGrande, L., Wheeler, K., Thorpe, L., Farfel, M., Brackbill, R. Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. American Journal of Psychiatry 164(9): 1385-1394, September 2007.
Pole, N., Best, S.R., Metzer, T., Marmar, C.R. Why are Hispanics at greater risk for PTSD? Cultural, Diversity and Ethnic Minority Psychology 11(2): 144-161, 2005.
Psychology Today. "Complex PTSD." Psychology Today, 2010.
Reeves, R.R. Diagnosis and management of posttraumatic stress disorder in returning veterans. Journal of the American Osteopathic Association 107(5): 181-189, May 2007.
Ruchkin, V., Schwab-Stone, M., Jones, S., Cicchetti, D.V., Koposov, R., Vermeiren. R. Is posttraumatic stress in youth a culture-bound phenomenon? A comparison of symptom trends in selected U.S. and Russian communities. American Journal of Psychiatry 162: 538-544, March 2005.
Ruzek, J. "Coping with PTSD and recommended lifestyle changes for PTSD patients." National Center for Post Traumatic Stress Disorder, May 22, 2007.
Schneider, S.L., L. Haack, J. Owens, et al. "An interdisciplinary treatment approach for soldiers with TBI/PTSD: issues and outcomes." Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders 19.2 June 2009: 36-46.
Schoenfeld, F.B., Marmar, C.R., Neylan, T.C. "Current concepts in pharmacotherapy for post traumatic stress disorder." Psychiatric Services 55 May 2004: 519-531.
Schuster, M.A., Stein, B.D., Jaycox, L.H., Collins, R.L., Marshall, G.N., Elliott, M.N., Zhou, A.J., Kanouse, D.E., Morrison, J.L., Berry, S.H. "A national survey of stress reactions after the September 11, 2001 terrorist attacks." New England Journal of Medicine 345.20 Nov. 15, 2001: 1507-1512.
Seng, J.S., Graham-Bermann, S.A., Clark, M.K., McCarthy, A.M., Ronis, D.L. "Posttraumatic stress disorder and physical comorbidity among female children and adolescents: results form service-use data." Pediatrics 116.6 December 2005: 767-776.
Smith, M.V., K. Poschman, and M.A. Cavaleri, et al. Symptoms of posttraumatic stress disorder in a community sample of low-income pregnant women. American Journal of Psychiatry 2006 May; 163: 881-884.
Udwin, O., Boyle, S., Yule, W., Bolton, D., O'Ryan, D. "Risk factors for long-term psychological effects of a disaster experienced in adolescence: predictors of post traumatic stress disorder." The Journal of Child Psychology and Psychiatry and Allied Disciplines 41 (2000): 969-979.
Vlahov, D., Galea, S., Resnick, H., et al. "Increased use of cigarettes, alcohol and marijuana among Manhattan, New York residents after the September 11th terrorist attacks." American Journal of Epidemiology 155.11 (2002): 988-996.
Winter, H., Irle, E. "Hippocampal volume in adult burn patients with and without posttraumatic stress disorder." American Journal of Psychiatry 161 (2004): 2194-2200.
Wu, P., Duarte, C.S., Mandell, D.J., Fan, B., Liu, X., Fuller, C.J., Musa, G., Cohen, M., Cohen, P., Hoven, C.W. "Exposure to the World Trade Center attack and the use of cigarettes and alcohol among New York City public high-school students." American Journal of Public Health 96.5 (2006): 804-807.
Yehunda, R., Engel, S. M., Brand, S.R., Seckl, J., Marcus, S.M., Berkowitz, G.S. "Transgenerational effects of post traumatic stress disorder in babies of mothers exposed to the World Trade Center attacks during pregnancy." The Journal of Clinical Endocrinology and Metabolism 90.7 (2005): 4115-4118.
Zayfert, C., DeViva, J., Hofmann, S.G. "Comorbid PTSD and social phobia in a treatment-seeking population: an exploratory study." The Journal of Nervous and Mental Disease 193.2 (2005): 93-101.
Posttraumatic Stress Disorder - Effective Treatments
What kinds of treatments have been effective for your posttraumatic stress disorder?Post View 25 Comments
Posttraumatic Stress Disorder - Symptoms
What symptoms did you experience with posttraumatic stress disorder?Post View 24 Comments
Posttraumatic Stress Disorder - Causes
What was the cause of PTSD in you or someone you know?Post View 5 Comments
Posttraumatic Stress Disorder - Coping
How do you cope with PTSD? What would you recommend to someone who is facing the challenges associated with PTSD?Post View 1 Comment
Posttraumatic Stress Disorder - Diagnosis and Assessment
What types of tests or exams helped assess and later diagnose your PTSD?Post
Posttraumatic Stress Disorder - Getting Help
What group or organization has helped you or a loved one cope with PTSD?Post
Top Posttraumatic Stress Disorder Related Articles
Alcohol Abuse and AlcoholismAlcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law. It can cause myriad health problems, including cirrhosis of the liver, birth defects, heart disease, stroke, psychological problems, and dementia. Counseling and a few medications can be effective for alcoholism treatment.
Angina SymptomsAngina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
CancerCancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Children's HealthChildren's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health, and community health.
DepressionDepression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Anxiety SlideshowLearn about generalized anxiety disorder (GAD). See if your worries are normal or something more by learning about symptoms, diagnosis, and treatments of anxiety disorders.
Loss, Grief, and BereavementGrief is the feeling one experiences after a loss (of a friendship, death of loved one, job). Complicated grief refers to grief that lasts for more than a year. Mourning describes the customs and rituals that help a bereaved individual make sense of their loss.
Take the PTSD QuizCan you have PTSD even if you've never been to war? Take the Posttraumatic Stress Disorder Quiz to learn about PTSD, who gets it, and why.
PsychotherapyPsychoteraphy is often the first form of treatment recommended for depression. Psychotherapy helps depression by helping people understand the behaviors, emotions and ideas that contribute to their depression, regain a sense of control and pleasure in life, and learn coping techniques as well as problem solving skills.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. The National Institutes of Health recommend about 7-9 hours of sleep each night for older, school-aged children, teens, and most average adults; 10-12 for preschool-aged children; and 16-18 hours for newborns. There are two stages of sleep; 1) REM sleep (rapid-eye movement), and 2) NREM sleep (non-rapid-eye movement). The side effects of lack of sleep or insomnia include:
- Feeling sleepy during the day
- Concentration or memory problems
Lack of sleep and insomnia can be caused by medical conditions or diseases, medications, stress, or pain. The treatment for lack of sleep and insomnia depends upon the cause.
StressStress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
SuicideSuicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.