Studies suggest that 40-90% of people will experience at least one traumatic event in their life time1. A traumatic event is a real or a perceived event that is shocking and emotionally overwhelming with serious injury or threat to physical integrity. The majority of people exposed to traumatic event don’t develop PTSD. The lifetime prevalence of PTSD is estimated at 7-12%2.
The risk for development of PTSD is associated with several factors including the type of exposure (sexual trauma being the most strongly associated), pre-existing psychopathology, personality features and coping strategies3. Individuals who use flexible coping strategies, by focusing on the experience and the meaning of the traumatic event as well as having the forward-focused view with optimism, helping others, goal-oriented thinking are less vulnerable to PTSD4. PTSD can be seen as a manifestation of a disrupted attachment bond. Secure attachment in childhood is strongly linked with one’s ability to regulate own emotions and is the primary defence against trauma induced psychopathology5. Social and family support have been shown to act as a buffer against traumatic events and play a protective role in PTSD6.
People with PTSD report having intrusive memories of the trauma with a vivid and strong sensory/perceptual character, disorganised in nature and accompanied by strong negative emotions. They also report “out of body” experience associated with their most prominent intrusive memories7. Re-experiencing episodes are always triggered involuntarily by internal or external cues. The flashbacks are too aversive and have to be avoided. The absence of detailed verbally accessible memories and high levels of negative emotions like shame and guilt can prevent inhibition of flashbacks8. Rates of substance use disorders and sleep disturbances such as insomnia, daytime sleepiness and nightmares are high in PTSD. Evidence suggests that substance use disorders can be means of coping with PTSD symptoms9. PTSD is also associated with high rates of other psychiatric comorbidities, e.g. commonly affective disorders (mainly depression) and anxiety disorders10. PTSD is linked to chronic diseases such as cardiovascular disease and type II diabetes, disease progression and earlier mortality11.
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Counselling and psychotherapy can help!12,13,14,15
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References:
1: Milani, A.C.C., Hoffmann, E., Fossaluza, V., Jackowski, A.P. & Mello, M.F. (2017). Does pediatric post-traumatic stress disorder alter the brain? Systematic review and meta-analysis of structural and functional magnetic resonance imaging studies. Psychiatry and Clinical Neurosciences. Vol. 71, 154-169.
2: Blanchette, I. & Caparos, S. (2016). Working memory function is linked to trauma exposure, independently of post-traumatic stress disorder symptom. Cognitive Neuropsychiatry. Vol. 21, No. 6, 494-509.
3: Perrin, M., Vandeleur, C.L., Castelao, E., Rothen, S., Glaus, J., Vollenweider, P. & Preisig, M. (2014). Determinants of the development of post-traumatic stress disorder, in the general population. Soc Psychiatry Psychiatr Epidemiol. Vol. 49., 447-457.
4: Rodin, R., Bonanno, G.A., Knuckey, S., Satterthwaite, M.L., Hart, R., Joscelyne, A., Bryant, R.A. & Brown, A.D. (2017). Coping flexibility predicts post-traumatic stress disorder and depression in human rights advocates. International Journal of Mental Health. Vol. 46, 327-338.
5: Zulueta, F. (2006). The treatment of psychological trauma from the perspective of attachment research. Journal of Family Therapy. Vol. 28, 334-351.
6: Aydin, B., Akbas, S., Turla, A. & Dundar, C. (2016). Depression and post-traumatic stress disorder in child victims of sexual abuse: Perceived social support as a protection factor. Nordic Journal of Psychiatry. Vol. 70, No. 6, 418-423.
7: Parry, L. & O’Kearney, R. (2014). A comparison of the quality of intrusive memories in post-traumatic stress disorder and depression. Memory. Vol. 22, No. 4, 408-425.
8: Brewin, C.R. (2001). Memory processes in post-traumatic stress disorder. International Review of Psychiatry. Vol. 13, 159-163.
9: Vandrey, R., Babson, K.A., Herrmann, E.S. & Bonn-Miller, M.O. (2014). Interactions between disordered sleep, post-traumatic stress disorder, and substance use disorders. International Review of Psychiatry. Vol. 26, No. 2, 237-247.
10: Dore, G., Mills, K., Murray, R., Teesson, M. & Farrugia, P. (2012). Post-traumatic stress disorder, depression and suicidality in inpatients with substance use disorders. Drug and Alcohol Review. Vol. 31, 294-302.
11: Roberts, A.L., Koenen, K.C., Chen, Q., Gilsanz, P., Mason, S.M., Prescott, J., Ratanatharanthorn, A., Rimm, E.B., Sumner, J.A., Winning, A., DeVivo, I. & Kubzansky, L.D. (2016). Postraumatic stress disorder and accelerated aging: PTSD and leukocyte telomere length in a sample of civilian women. Depress Anxiety. Vol. 34, 391-400.
12: Baker, R., Gale, L., Abbey, G. & Thomas, S. (2013). Emotional Processing Therapy for post traumatic stress disorder. Counselling Psychology Quarterly. Vol. 26, No. 3-4, 362-385.
13: Brom, D., Stokar, Y., Lawi, C., Nuriel-Porat, V., Ziv, Y., Lerner, K. & Ross, G. (2017). Somatic Experiencing for posttraumatic stress disorder: A randomised controlled outcome study. Journal of Traumatic Stress. Vol. 30, 304-312.
14: Dinnen, S., Simiola, V. & Cook, J.M. (2015). Post-traumatic stress disorder in older adults: A systematic review of the psychotherapy treatment literature. Aging & Mental Health. Vol. 19, No. 2, 144-150.
15: Ehlers, A., Clark, D.M. (2008). Post-traumatic stress disorder: The development of effective psychological treatments. Nord J Psychiatry. Vol. 62, 11-18.