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If trauma, then ptsd: busting the media fallacy of ptsd prevalence

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anthony

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The media writes stories and scripts television in such a way that it seems as though everyone who endures a traumatic event will develop Post Traumatic Stress Disorder (PTSD). You've seen this with combat operation reporting over the past decade. If you don't think your loved one is coming home with PTSD after being deployed into combat, then you must not own a TV.

Don't believe everything you read or watch on TV. News is hyperbolic -- exaggerated and edited to get viewer attention in order to sell ad space to pay the bills. Factually, quite the opposite is true; a minority obtain PTSD when exposed to traumatic events. In fact, the evidence to date uses the word "rare" when talking about PTSD as a consequence to catastrophic trauma (Dead Link Removed).

How is it that such exposure does or does not lead to the development of PTSD? It's called resilience. Resilience is influenced by diverse genetic, epigenetic, developmental, neurobiological and psychosocial factors. These factors interact in a complex web with multiple risk and protective factors associated with vulnerability or resilience to stress and trauma.

People tend to be more resilient in specific domains of their lives, than others. The same holds true for enduring catastrophic traumatic events, in that some have higher statistical rates for PTSD than others.

Examples speak best. While not empirically accurate, the following statistics are based on approximations from relevant studies.

If 100,000 troops are deployed into combat operations for a six-month period, it is likely 30% (30,000) will show PTSD symptoms on return. Within six months of return -- doing nothing other than reintegration with normal duties and society -- that figure will halve. This remaining 15% may require additional support, such as therapy or more time, to reduce symptoms and become functional within society again. Of this original 30%, approximately 5% (1,500) of soldiers will obtain lifetime PTSD.

When troops are redeployed on second and subsequent tours, these statistics increase significantly. Retraumatization occurs, and troops not affected by their first deployment may now become affected with PTSD symptoms.

Rape statistics vary. If one takes a sample of 100,000 rape victims, the initial statistics for PTSD symptoms are lower, likely around 20% (20,000). Rinse and repeat the above with time, therapy and then a smaller amount may obtain lifetime PTSD. Again, repeated exposure increases the statistics exponentially, increasing the percentage for PTSD.

Motor Vehicle Accidents (MVAs) have a low rate for PTSD. For every 100,000 MVAs, you may be lucky that 2% - 5% demonstrate PTSD symptoms. Of that, maybe 50 - 200 people obtain debilitating PTSD symptoms.

In some countries, PTSD prevalence is as high as 60-70% of the population.

Whilst different types of trauma have statistical variance, what is statistically known is that repeated exposure exponentially increases risk for PTSD. Put simply, everyone has a breaking point when encountering trauma.

Overall, PTSD is a rare outcome from traumatic events. Resilience is proving to be an aspect of interesting study, demonstrating how we overcome, adapt and learn positively from otherwise negative experiences.

Anxiety and depression are the most likely outcome from experiencing traumatic events. These two disorders can look similar to PTSD, yet these are very normal to experience and have extremely high recovery rates.

The most important message one can glean from the hyperbolic media attention PTSD has garnered is this: PTSD can happen to anyone, given enough exposure to risk factors, though its occurrence as a chronic condition is rare. Those charged with supporting friends, spouses, and family who have endured traumatic experiences can be allies in resilience by providing support, withholding undue judgment, and contributing to the successful reintegration of those attempting to regain normalcy following abnormal and catastrophic circumstance.
 
Very interesting article. Thank you for your concise statistical notes and overview. I found it a very informative snapshot of the bigger picture without being long to read! I’d be interested to learn which countries are reporting at 60-70% of the population suffering p.t.s./d.? I’m imagining it would the conflict-ridden war zones?

I attended an amazing lecture by a man who works with Vietnam veterans therapeutically by taking them back to Vietnam on a healing tour…they go to the places where the atrocities happened, and reconnect with the locals, i.e. the other survivors of the atrocities (possibly the victims of their own actions). The amazing thing is, according to the lecturer, there is zero incidence of p.t.s.d in the Vietnam population, including all the survivors of the horrors of the war. In fact it is these people, in their loving and forgiving (i.e. spiritually buddhist) way of life, that seem to hold the key to healing the American vets. Some of the pictures he showed us were astonishing. Vets who were broken with survivor shame and could not even look into the camera before leaving the States, opening up in loving embrace with their Vietnamese counterparts, and experiencing a true healing on the other side of the ocean. We could learn a lot from these examples…p.t.s.d. here tends to be pathologized to the individual level as do all mental health disorders in our society, however the above information reframes it and our capacity for resilience in terms of the context of the society we find ourselves living in.
 
“I’d be interested to learn which countries are reporting at 60-70% of the population suffering p.t.s./d.?”

Yes, war torn countries. For example, Algeria’s trauma exposure is approximately 92%, with actual PTSD at approximately 38%. You could double that if you diagnosed according to the DSM for one month of symptoms, though the majority are still recovering due to resilience.

There are locations in Africa where PTSD is off the charts, again, specific war torn regions that have been in and out of conflict for long periods.

I do wonder whether the rates are higher in locations where conflict is on again, off again, versus where conflict is just on always, such as Middle East locations. It seems that countries with constant war, it just becomes the norm of which everyone is adjusted and that is life, thus PTSD is not present, but instead specific symptoms, well… what we pathologize as symptoms, is simply survival instincts for them.

I also have read aspects about countries where PTSD is just non-existent. I was reading about Tibet and buddhism, how when they have someone who is traumatised they pretty much surround them with support and talk the hell out of it until they rationalise things once again and are helped and motivated back into productivity. They fall down, the entire community surrounds them to heal, recover and get on with life.

Western society runs away from mental health, we stigmatise it, where others embrace it and make it part of their culture to 24/7 support someone enduring mental health issues towards full recovery. Who has it right and who has it wrong? Not a hard answer that one.
 
What about childhood sexually abuse? Those numbers far surpass all other groups, especially since more and more “adults” seek to fulfill their demonic activity with helpless children.
 
“Those numbers far surpass all other groups”

Children have more resilience than adults for trauma, which is evidenced. Where are you sourcing that information for your basis?

Childhood abuse, where it is ongoing, follows the same path as any trauma for repeated exposure, though again, children have statistically demonstrated far greater resilience to traumatic exposure than if the same trauma occurred in adulthood.

What I would deem to be something of an authoritative figure, is Link Removed

They cite: “about 12 out of every 1,000 children up to age 18 in the United States were found to be victims of maltreatment in 2005.”

Neglect 62.8%
Physical abuse 16.6%
Sexual abuse 9.3%
Emotional/psychological abuse 7.1%
Medical neglect 2.0%
Other 14.3%

The figures are much lower than you think for childhood abuse. Yes, there are always unreported cases, yet there are always unreported cases for every type of trauma that does not require medical intervention. Even then, excuses get made so it can’t be reported as a statistic.

If you look at historical graphs, people think abuse is happening more, where it is factually getting less. Populations are increasing, traumatic occurrence is decreasing in most areas, yet some increases are present in other areas of functioning.

It is a misconception that the world is getting worse, where statistics are showing that the world is getting better, especially with things such as childhood abuse. Yes, it is still happening, but it is far less prominent now due to such awareness society has of it.
 
Let’s not forget about Public Safety Folks. We deal with traumas multiple times a shift. 8 years of that on top of personal, near death and sexual traumas earlier in life. I’m one of those “lifetime folks” and I’m willing to bet alot of former cops and medics are the same.
 
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