Posttraumatic Stress Disorder

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Posttraumatic stress disorder (PTSD) is one of many possible long-term outcomes resulting from traumatic events, including exposure to combat and operational stress. It is very common for individuals to experience symptoms of post-traumatic stress following a dangerous or violent experience. These symptoms include:

  • Nightmares and unwanted thoughts about the event

  • Avoidance of places and situations that remind one of the traumatic event

  • Troubling thoughts and feelings related to the event

  • Difficulty with sleep and concentration

  • Feeling on edge or easily startled

Everyone responds to stress and trauma differently, and fewer than 10 percent of people who experience a trauma develop PTSD. [ Reference 1 ] For the vast majority of people, post-traumatic stress symptoms resolve on their own within days or weeks of the event. Following exposure to trauma, getting support may prevent these stress reactions from getting worse and prevent an individual from turning to unhealthy coping methods, such as substance misuse. Find links to current evidence-based guidelines for PTSD, which include recommendations for preventing PTSD after exposure to a traumatic event. Learn more about PTSD prevention, screening, and treatment in the PTSD section.

Combat and operational stress reactions (COSRs) and PTSD share some common warning signs; however, COSRs and PTSD are not the same. COSRs are expected and often transient reactions to high-stress and potentially traumatic events. PTSD, meanwhile, is a psychological health disorder associated with exposure to a traumatic event(s) and characterized by chronic symptoms. PTSD has specific criteria that must be met for diagnosis. [ Reference 2 ]

Resources

The following resources can support service members, leaders, and providers in addressing PTSD.

  • Combat Stress and PTSD: Knowing the Difference This article from the U.S. Army can help line leaders distinguish between combat stress and PTSD.
  • Post-Traumatic Stress Disorder This section of the National Institute of Mental Health website provides an overview, offers information on signs and symptoms, and describes factors that are associated with increased risk for developing PTSD following a traumatic experience and provides resilience factors that support coping after a traumatic event.
  • Self Help and Coping This web page from the U.S. Department of Veterans Affairs’ National Center for PTSD describes information on what to expect after a traumatic event and offers self-help tools and strategies to manage stress reactions.
  • VA/DoD Clinical Practice Guidelines for the Management of Posttraumatic Stress Disorder and Acute Stress Reaction 2017 This guideline, which is intended to improve patient outcomes and local management of patients with posttraumatic stress disorder or acute stress reaction, describes the critical decision points for practitioners in the management of these conditions and provides clear and comprehensive evidence-based recommendations incorporating current information and practices.
  • PTSD The Real Warriors Campaign website offers a variety of resources on PTSD.
  • Counseling Options for Service Members and Their Families This web page from Military OneSource provides a list of options for in-person, web-based, and phone counseling for service members and their families.

References

  1. Kessler, R.C., Berglund, P., Delmer, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6): 593-602, Kessler, R.C., Sonnega, A., Bromet, E. Hughes, M., & Nelson, C.B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048-1060, Kilpatrick, D. G., Resnick, H. S., Milanak, M. E., Miller, M. W., Keyes, K. M., & Friedman, M. J. (2013). National Estimates of Exposure to Traumatic Events and PTSD Prevalence Using DSM-IV and DSM-5 Criteria. Journal of Traumatic Stress, 26(5), 537–547. http://doi.org/10.1002/jts.21848

  2.   Brusher, E. A. (2011). Combat and Operational Stress. In E.C. Ritchie (Ed.), Combat and Operational Behavioral Health (pp 107-119).  Falls Church, VA: Office of the Surgeon General, U.S. Army and Fort Detrick, MD:  Borden Institute. Retrieved from https://ke.army.mil/bordeninstitute/published_volumes/combat_operational/CBM-ch4-final.pdf