Although it’s rare, there is clinical evidence of late-onset PTSD. Some cases suggest that women who have been sexually abused start exhibiting symptoms when their child reaches the same age the mother was when she was abused. There are also war veterans who experience symptoms (notably, depression) when they retire, presumably because they have more time for reflection. One Vietnam veteran we spoke with, who lives in New York City, said that the burning smell in the air after 9/11 triggered new episodes for him. He also said that some Iraq War veterans from his vet counseling group are reluctant to leave the hospital. Fearful of an explosion, the soldiers don’t want to walk near parked cars. Some people are more prone than others. Whether someone reacts to an event with a post-traumatic stress disorder is largely dependent on the severity of the event, or stressor, itself. Sexual assault, for one, is more likely to produce PTSD than other horrible experiences. Dr. Elana Newman, president of the International Society for Traumatic Stress Studies, explains that one’s personal history also plays a role. “There’s evidence in psychology that prior problems predict future problems—that if you’ve had trouble in the past, you’ll have trouble in the future,” she says. “Prior psychiatric disorders, particularly depression, anxiety and substance abuse, are risk factors for post-traumatic stress disorder.” This notion also helps explain why widows, divorcees and people with instability in their families may be more prone to PTSD. Being victimized by racial discrimination—itself a form of ongoing trauma—is a risk factor as well. In children, PTSD can sometimes appear concurrently with ADHD. Researchers are trying to figure out whether some children suffering from learning deficits are actually experiencing post-traumatic stress. In these terror-fearing times, there’s more attention on prevention. Police, firemen, soldiers, and ER doctors all stand to see some terrible things—some of them on a daily basis. There’s a lot of work being done for them on two fronts. One is resiliency training; though in its infancy, the research involves figuring out who is at risk and the best way to prevent subsequent problems. Another is “critical instance stress debriefing,” a treatment where people talk in groups about what happened. The practice is somewhat controversial because a few people who undertook this method of intervention actually seemed to exhibit more severe symptoms afterwards. The problem with preparing the general population (against a reaction to acts of terrorism, for instance) is that reactions are highly individualized—that is, everyone responds differently. In light of that reality, researchers are currently looking for genetic components to PTSD, which may lead to new medicinal treatments. The way each of us responds to a distressing event may be wired into our biology, which opens to the door to new medicinal treatments. PTSD is a disorder, not a weakness. As if experiencing a life-altering trauma were not enough, people with PTSD are often plagued by shame at their own reaction. “One of the general assumptions about any stress disorder is that if you have symptoms, it’s because you’re weak,” says Newman. “But there are some things that require help. And the amazing thing is that we really do have effective treatments, both pharmacological and psychological. They’re not easy treatments because they require going back and visiting something that is very painful. But in a short time, most people can experience a great deal of relief.” Trauma is universal, but PTSD may not be. According to a recent article in the New York Times Magazine, the way people respond to trauma may be greatly influenced by the culture of their homeland. Several people who survived the 2004 tsunami in Asia, or the wars in Afghanistan, Bosnia and Guatemala, were seen to exhibit symptoms quite different from those we use in America to diagnose and define PTSD. Indications ranged from a feeling of intense heat in the body to visions of vengeful spirits. The following organizations provide helpful information to begin addressing post-traumatic stress disorder. * The International Society for Traumatic Stress Studies * The National Center for PTSD * National Child Traumatic Stress Network * National Institutes for Mental Health Reality Check: Post-Traumatic Stress Disorder has been reviewed for accuracy by Elana Newman, Ph.D., president of the International Society for Traumatic Stress Studies and professor of clinical psychology at University of Tulsa, Okla.