Questions about Post-traumatic stress disorder

Short answers, pulled from the story.

When was post-traumatic stress disorder officially added to the Diagnostic and Statistical Manual of Mental Disorders?

Post-traumatic stress disorder was officially added to the Diagnostic and Statistical Manual of Mental Disorders in 1980. The term entered the DSM-III that year, heavily influenced by the experiences of Vietnam War veterans. This addition marked a shift from viewing the condition as a sign of weakness to recognizing it as a physiological and psychological response to extreme stress.

What physical changes occur in the brain of a person with post-traumatic stress disorder?

A 2007 study of Vietnam War combat veterans revealed that those with post-traumatic stress disorder had a 20% reduction in the volume of their hippocampus compared to veterans without the symptoms. The amygdala becomes hyperactive while the hippocampus and the medial prefrontal cortex fail to exert their inhibitory control, creating a state of chronic hyperarousal. Biochemical changes include low secretion of cortisol and high secretion of catecholamines, resulting in a norepinephrine-to-cortisol ratio that is significantly higher than in non-diagnosed individuals.

What percentage of adults in the United States have post-traumatic stress disorder in a given year?

In the United States, about 3.5% of adults have post-traumatic stress disorder in a given year. The global picture reveals a stark disparity in prevalence, with rates in much of the rest of the world during a given year being between 0.5% and 1%. Rates skyrocket to 6% and 15% respectively in war-exposed or less economically developed countries.

Which treatments have the strongest evidence for reducing symptoms of post-traumatic stress disorder?

The approaches with the strongest evidence include behavioral and cognitive-behavioral therapies such as prolonged exposure therapy, cognitive processing therapy, and eye movement desensitization and reprocessing. A 2018 systematic review found moderate strength of evidence to support the efficacy of eye movement desensitization and reprocessing for reduction in symptoms, loss of diagnosis, and reduction in depressive symptoms. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors are the first-line medications used for the disorder and are moderately beneficial for about half of people.

How does culture influence the understanding and diagnosis of post-traumatic stress disorder?

Cultural and medical anthropologists have questioned the validity of applying the diagnostic criteria of post-traumatic stress disorder cross-culturally as the primarily Euro-American research on trauma is necessarily limited. In Nepal, ethnopsychology studies have found that cultural idioms and concepts related to trauma often do not translate to western terminologies, with the term piDaa aligning to trauma and suffering but also indicating that people who suffer from it are considered mad and subject to negative social stigma. Anthropologists believe applying the term social suffering or cultural bereavement to be more beneficial for trauma that extends beyond the individual.

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