Post-traumatic stress disorder

Short description: Mental disorder associated with trauma

"PTSD" redirects here. For other uses, see PTSD (disambiguation). For C-PTSD, see Complex post-traumatic stress disorder.

Post-traumatic stress disorder

Specialty| Psychiatry, clinical psychology
Symptoms| Disturbing thoughts, feelings, or dreams related to the event; mental or physical distress to trauma-related cues; efforts to avoid trauma-related situations; increased fight-or-flight response[1]
Complications| Suicide; cardiac, respiratory, musculoskeletal, gastrointestinal, and immunological disorders[2]
Duration| > 1 month[lower-alpha 1]
Causes| Exposure to a traumatic event[1]
Diagnostic method| Based on symptoms[2]
Treatment| Counseling, medication,[4] selective serotonin reuptake inhibitors[5]
Frequency| 8.7% (lifetime risk); 3.5% (12-month risk) (US)[6]

Post-traumatic stress disorder (PTSD)[lower-alpha 2] is a mental disorder that develops from experiencing a traumatic event, such as sexual assault, domestic violence, child abuse, warfare and its associated traumas, natural disaster, bereavement, traffic collision, or other threats on a person's life or well-being.[1][7][8] Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response.[1][4][9] These symptoms last for more than a month after the event and can include triggers such as misophonia.[1] Young children are less likely to show distress, but instead may express their memories through play.[10][1]

Most people who experience traumatic events do not develop PTSD.[2] People who experience interpersonal violence such as rape, other sexual assaults, being kidnapped, stalking, physical abuse by an intimate partner, and childhood abuse are more likely to develop PTSD than those who experience non-assault based trauma, such as accidents and natural disasters.[11][12][13] In the United States, about 3.5% of adults have PTSD in a given year, and 9% of people develop it at some point in their lives.[1] In much of the rest of the world, rates during a given year are between 0.5% and 1%.[1] Higher rates may occur in regions of armed conflict.[2] It is more common in women than men.[14]

A recent systematic review and meta-analysis reported that the pooled prevalence rates for ICD-11 PTSD and complex PTSD were 2% and 4%, respectively, among adults in non-war-exposed/economically developed countries/regions; they increased to 6% and 15%, respectively, in war-exposed/less economically developed countries/regions.[15]

Prevention may be possible when counselling is targeted at those with early symptoms, but is not effective when provided to all trauma-exposed individuals regardless of whether symptoms are present.[2] The main treatments for people with PTSD are counselling (psychotherapy) and medication.[4][16] Most combination therapy (psychotherapy and pharmacotherapy) does not seem to be more effective than psychotherapy alone,[2][17] except for MDMA-assisted psychotherapy.[18] Benefits from medication are less than those seen with counselling.[2] Antidepressants of the SSRI or SNRI type are the first-line medications used for PTSD and are moderately beneficial for about half of people.[5] Medications, other than some SSRIs or SNRIs, do not have enough evidence to support their use and, in the case of benzodiazepines, may worsen outcomes.[19][20]

Symptoms of trauma-related mental disorders have been documented since at least the time of the ancient Greeks.[21] A few instances of evidence of post-traumatic illness have been argued to exist from the seventeenth and eighteenth centuries, such as the diary of Samuel Pepys, who described intrusive and distressing symptoms following the 1666 Fire of London.[22] During the world wars, the condition was known under various terms, including "shell shock", "war nerves", neurasthenia and 'combat neurosis'.[23][24] The term "post-traumatic stress disorder" came into use in the 1970s, in large part due to the diagnoses of U.S. military veterans of the Vietnam War.[25] It was officially recognized by the American Psychiatric Association in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).[26]

## Contents

* 1 Signs and symptoms
* 1.1 Associated medical conditions
* 2 Risk factors
* 2.1 Trauma
* 2.1.1 Intimate partner and sexual violence
* 2.1.2 War-related trauma, refugees
* 2.1.3 Unexpected death of a loved one
* 2.1.4 Life-threatening or severe illness
* 2.1.5 Psychosis spectrum conditions
* 2.1.6 Cancer
* 2.1.7 Pregnancy-related trauma
* 2.1.8 Natural disasters
* 2.2 Genetics
* 2.3 Evolutionary Perspectives
* 3 Pathophysiology
* 3.1 Neuroendocrinology
* 3.2 Neuroimmunology
* 3.3 Neuroanatomy
* 4 Diagnosis
* 4.1 Screening
* 4.2 Assessment
* 4.3 In the DSM and ICD
* 4.4 Differential diagnosis
* 5 Prevention
* 5.1 Psychological debriefing
* 5.2 Early intervention
* 5.3 Risk-targeted interventions
* 6 Management
* 6.1 Combination therapy
* 6.2 Counselling
* 6.2.1 Cognitive behavioral therapy
* 6.2.2 Eye movement desensitization and reprocessing
* 6.2.3 Interpersonal psychotherapy
* 6.3 Medication
* 6.3.1 Antidepressants
* 6.3.2 Benzodiazepines
* 6.3.3 Prazosin
* 6.3.4 Glucocorticoids
* 6.3.5 Cannabinoids
* 6.4 Other
* 6.4.1 Exercise, sport and physical activity
* 6.4.2 Play therapy for children
* 6.4.3 Military programs
* 6.4.4 Nightmares
* 7 Epidemiology
* 7.1 United States
* 7.1.1 Military combat
* 7.1.2 Human-made disasters
* 8 Anthropology
* 9 Veterans
* 9.1 United States
* 9.2 United Kingdom
* 9.3 Canada
* 10 History
* 11 Terminology
* 12 Research
* 12.1 Psychotherapy
* 13 See also
* 14 Notes
* 15 References
* 16 External links

## Signs and symptoms

Service members use art to relieve PTSD symptoms.

See also: Biology:Psychological stress and sleep

Symptoms of PTSD generally begin within the first three months after the inciting traumatic event, but may not begin until years later.[27][4] In the typical case, the individual with PTSD persistently avoids either trauma-related thoughts and emotions or discussion of the traumatic event and may even have amnesia of the event (dissociative amnesia).[1] However, the event is commonly relived by the individual through intrusive, recurrent recollections, dissociative episodes of reliving the trauma ("flashbacks"), and nightmares (50 to 70%).[28][29][30] While it is common to have symptoms after any traumatic event, these must persist to a sufficient degree (i.e., causing dysfunction in life or clinical levels of distress) for longer than one month after the trauma to be classified as PTSD (clinically significant dysfunction or distress for less than one month after the trauma may be acute stress disorder).[1][31][32] Some following a traumatic event experience post-traumatic growth.[33] The social interactions of people experiencing trauma may influence their PTSD symptoms, including critical comments by partners making the victim feel guilty.[34][needs update]

### Associated medical conditions

Trauma survivors often develop depression, anxiety disorders, and mood disorders in addition to PTSD.[35] More than 50% of those with PTSD have co-morbid anxiety, mood, or substance use disorders.[36]

Substance use disorders, such as alcohol use disorder, commonly co-occur with PTSD.[37] Recovery from post-traumatic stress disorder or other anxiety disorders may be hindered, or the condition worsened, when substance use disorders are comorbid with PTSD. Resolving these problems can bring about improvement in an individual's mental health status and anxiety levels.[38][39]

PTSD has a strong association with tinnitus,[40] and speculation exists that PTSD may cause some tinnitus seen in association with the condition.[41]

PTSD is also associated with several physical health comorbidities that involve inflammatory processes and immune system dysregulation.[42]

In children and adolescents, there is a strong association between emotional regulation difficulties (e.g., mood swings, anger outbursts, temper tantrums) and post-traumatic stress symptoms, independent of age, gender, or type of trauma.[43]

Moral injury, the feeling of moral distress, such as shame or guilt following a moral transgression, is associated with PTSD but is distinguished from it. Moral injury is associated with shame and guilt, while PTSD is associated with anxiety and fear.[44]: 2,8,11

## Risk factors

Persons considered at risk for developing PTSD include combat military personnel, survivors of natural disasters, concentration camp survivors, and survivors of violent crime. Persons employed in occupations that expose them to violence (such as soldiers) or disasters (such as emergency service workers) are also at risk.[45] Other occupations at an increased risk include police officers, firefighters,[46] first responders, ambulance personnel, health care professionals, train drivers, divers, journalists, and sailors, as well as people who work at banks, post offices, or in stores.[47] The intensity of the traumatic event is also associated with a subsequent risk of developing PTSD, with experiences related to witnessed death, or witnessed or experienced torture, injury, bodily disfigurement, traumatic brain injury being highly associated with the development of PTSD. Similarly, experiences that are unexpected or in which the victim cannot escape are also associated with a high risk of developing PTSD.[36]

### Trauma

Main article: Medicine:Psychological trauma

See also: Psychological resilience

PTSD has been associated with a wide range of traumatic events. The risk of developing PTSD after a traumatic event varies by trauma type[48][49] and is the highest following exposure to torture (40%)[50] and sexual violence (11.4%), particularly rape (19.0%).[51] Men are more likely to experience a traumatic event (of any type), but women are more likely to experience the kind of high-impact traumatic event that can lead to PTSD, such as interpersonal violence and sexual assault.[52]

Motor vehicle collision survivors, both children and adults, are at an increased risk of PTSD.[53][54] Globally, about 2.6% of adults are diagnosed with PTSD following a non-life-threatening traffic accident, and a similar proportion of children develop PTSD.[51] Risk of PTSD almost doubles to 4.6% for life-threatening auto accidents.[51] Females were more likely to be diagnosed with PTSD following a road traffic accident, whether the accident occurred during childhood or adulthood.[53][54]

Post-traumatic stress reactions have been studied in children and adolescents.[55] The rate of PTSD might be lower in children than adults, but in the absence of therapy, symptoms may continue for decades.[56] One estimate suggests that the proportion of children and adolescents having PTSD in a non-wartorn population in a developed country may be 1% compared to 1.5% to 3% of adults.[56] On average, 16% of children exposed to a traumatic event develop PTSD, with the incidence varying according to the type of exposure and gender.[57] Similar to the adult population, risk factors for PTSD in children include: female gender, exposure to disasters, maladaptive coping behaviors,[58] or lacking proper social support systems.[59]

Predictor models have consistently found that childhood trauma, chronic adversity, neurobiological differences, and familial stressors are associated with risk for PTSD after a traumatic event in adulthood.[60][61][62] It has been difficult to find consistently predictive aspects of the events that predict, but peritraumatic dissociation has been a fairly consistent predictive indicator of the development of PTSD.[63] Proximity to, duration of, and severity of the trauma make an impact. It has been speculated that interpersonal traumas cause more problems than impersonal ones,[64] but this is controversial.[65] The risk of developing PTSD is increased in individuals who are exposed to physical abuse, physical assault, or kidnapping.[66][67] Women who experience physical violence are more likely to develop PTSD than men.[66]

#### Intimate partner and sexual violence

See also: Rape trauma syndrome

An individual that has been exposed to domestic violence is predisposed to the development of PTSD. There is a strong association between the development of PTSD in mothers who experienced domestic violence during the perinatal period of their pregnancy.[68]

Those who have experienced sexual assault or rape may develop symptoms of PTSD.[69][70] The likelihood of sustained symptoms of PTSD is higher if the rapist confined or restrained the person, if the person being raped believed the rapist would kill them, the person who was raped was very young or very old, and if the rapist was someone they knew. The likelihood of sustained severe symptoms is also higher if people around the survivor ignore (or are ignorant of) the rape or blame the rape survivor.[71]

#### War-related trauma, refugees

Service members are exposed to traumatic events during war. After deployment, to a combat zone, exposure to life-threatening situations is common.Other common events could be injury or death, been in a serious accident or handled human remains.

Military service in combat is a risk factor for developing PTSD.[36] Around 22% of people exposed to combat develop PTSD; in about 25% of military personnel who develop PTSD, its appearance is delayed.[36]

Refugees are also at an increased risk for PTSD due to their exposure to war, hardships, and traumatic events. The rates for PTSD within refugee populations range from 4% to 86%.[72] While the stresses of war affect everyone involved, displaced persons are more so than others.[73]

Challenges related to the overall psychosocial well-being of refugees are complex and individually nuanced. Refugees have reduced levels of well-being and a high rate of mental distress due to past and ongoing trauma. Groups that are particularly affected and whose needs often remain unmet are women, older people, and unaccompanied minors.[74] Post-traumatic stress and depression in refugee populations also tend to affect their educational success.[74]

#### Unexpected death of a loved one

Sudden, unexpected death of a loved one is the most common traumatic event type reported in cross-national studies.[51][75] However, the majority of people who experience this type of event will not develop PTSD. An analysis from the WHO World Mental Health Surveys found a 5.2% risk of developing PTSD after learning of the unexpected death of a loved one.[75] Because of the high prevalence of this type of traumatic event, the unexpected death of a loved one accounts for approximately 20% of PTSD cases worldwide.[51]

#### Life-threatening or severe illness

Medical conditions associated with an increased risk of PTSD include cancer,[76][77][78] heart attack,[79] and stroke.[80] 22% of cancer survivors present with lifelong PTSD like symptoms.[81] Intensive-care unit (ICU) hospitalization is also a risk factor for PTSD.[82] Some women experience PTSD from their experiences related to breast cancer and mastectomy.[83][84][76] Loved ones of those who experience life-threatening illnesses are also at risk for developing PTSD, such as parents of a child with chronic illnesses.[85]

#### Psychosis spectrum conditions

Research exists that demonstrates that survivors of psychotic episodes, which exist in diseases such as schizophrenia, schizoaffective disorder, bipolar I disorder, and others, are at greater risk of developing PTSD. This is often due to the experiences one may have during and after psychosis. Such traumatic experiences include, but are not limited to, experiences in psychiatric hospitals, police interactions, social stigma, and embarrassment due to psychotic behavior, suicidal behavior and attempts, distressing delusions and hallucinations, and the fear of losing control or actual loss of control. The incidence of PTSD in survivors of psychosis may be as low as 11% and as high at 67%.[86][87][88]

#### Cancer

Prevalence estimates of cancer‐related PTSD range between 7% and 14%,[89] with an additional 10% to 20% of patients experiencing subsyndromal post-traumatic stress symptoms (PTSS).[90][91] Both PTSD and PTSS have been associated with increased distress and impaired quality of life,[92] and have been reported in newly diagnosed patients as well as in long‐term survivors.[93]

The PTSD Field Trials for the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV), revealed that 22% of cancer survivors present with lifetime cancer-related PTSD (CR-PTSD), endorsing cancer diagnosis and treatment as a traumatic stressor.[94]

Therefore, as the number of people diagnosed with cancer increases and cancer survivorship improves, cancer-related PTSD becomes a more prominent issue, so providing for cancer patients' physical and psychological needs becomes increasingly important.[95]

#### Pregnancy-related trauma

Main article: Medicine:Childbirth-related post-traumatic stress disorder

Women who experience miscarriage are at risk of PTSD.[96][97][98] Those who experience subsequent miscarriages have an increased risk of PTSD compared to those experiencing only one.[96] PTSD can also occur after childbirth and the risk increases if a woman has experienced trauma before the pregnancy.[99][100] Prevalence of PTSD following normal childbirth (that is, excluding stillbirth or major complications) is estimated to be between 2.8 and 5.6% at six weeks postpartum,[101] with rates dropping to 1.5% at six months postpartum.[101][102] Symptoms of PTSD are common following childbirth, with prevalence of 24–30.1%[101] at six weeks, dropping to 13.6% at six months.[103] Emergency childbirth is also associated with PTSD.[104]

#### Natural disasters

People who experience natural disasters such as floods, earthquakes, tsunamis, hurricanes, and fires can develop post-traumatic stress disorder.[105] A literature review of studies examining PTSD following disasters between 1980 and 2007 found that the prevalence of PTSD after natural disasters was lower than the prevalence of the condition after man-made disasters. This review found prevalence rates between 3.7% to 60%. Research has shown that PTSD impacts approximately one in four earthquake survivors (23.66%).[106] Determinants of the risk of PTSD developing after disaster include the extent of physical injury, risk of life, and number of fatalities.[107] Geographical proximity to the epicenter of a natural disaster has been shown to contribute to people developing PTSD.[108] Natural disasters can displace families and challenge people's sense of control and security.[109] Mental health recovery of individuals, communities and countries after emergencies, including natural disasters, is important for social and economic reasons. Mental health emergency preparedness and response need to be effective after natural disasters.[110]

### Genetics

Main article: Biology:Genetics of post-traumatic stress disorder

There is evidence that susceptibility to PTSD is hereditary. Approximately 30% of the variance in PTSD is caused by genetics alone.[63] For twin pairs exposed to combat in Vietnam, having a monozygotic (identical) twin with PTSD was associated with an increased risk of the co-twin's having PTSD compared to dizygotic twins (non-identical twins).[111] Women with a smaller hippocampus might be more likely to develop PTSD following a traumatic event based on preliminary findings.[112] Research has also found that PTSD shares many genetic influences common to other psychiatric disorders. Panic and generalized anxiety disorders, and PTSD share 60% of the same genetic variance. Alcohol, nicotine, and drug dependence share greater than 40% genetic similarities.[63] Neuroscientist Dr. Rachel Yehuda researched how psychological trauma can travel across generations, specifically focusing on trans-generational trauma with Holocaust survivors and their offspring. The researchers in her study focused on a stress gene called FKBP5 that is linked to PTSD. The results of this study underscore the genetic components of PTSD as they showed an effect on methylation of the FKBP5 gene both in the parents who experienced trauma in concentration camps, as well as their offspring.[113]

### Evolutionary Perspectives

Evolutionary Psychiatry and Evolutionary Psychology perspectives interpret PTSD symptoms as extreme or dysregulated forms of defensive responses that were advantageous in ancestral contexts.[114] Hypervigilance, intrusive memories, and exaggerated startle responses may reflect overactivation of mechanisms designed to promote survival after trauma.[115] While these accounts can help contextualize symptom clusters, reviews emphasize that they remain theoretical and require integration with neurobiological and psychosocial research.

## Pathophysiology

### Neuroendocrinology

PTSD symptoms may result when a traumatic event causes an overreactive adrenaline response, which creates deep neurological patterns in the brain. These patterns can persist long after the event that triggered the fear, making an individual hyper-responsive to future fearful situations.[31][116] During traumatic experiences, the high levels of stress hormones secreted suppress hypothalamic activity that may be a major factor toward the development of PTSD.[117]

PTSD causes biochemical changes in the brain and body that differ from other psychiatric disorders, such as major depression. Individuals diagnosed with PTSD respond more strongly to a dexamethasone suppression test than individuals diagnosed with clinical depression.[118][119]

Most people with PTSD show a low secretion of cortisol and high secretion of catecholamines in urine,[120] with a norepinephrine/cortisol ratio consequently higher than comparable non-diagnosed individuals.[121] This is in contrast to the normative fight-or-flight response, in which both catecholamine and cortisol levels are elevated after exposure to a stressor.[122]

Brain catecholamine levels are high,[123] and corticotropin-releasing factor (CRF) concentrations are high.[124][125] Together, these findings suggest abnormality in the hypothalamic-pituitary-adrenal (HPA) axis.

The maintenance of fear has been shown to include the HPA axis, the locus coeruleus-noradrenergic systems, and the connections between the limbic system and frontal cortex. The HPA axis that coordinates the hormonal response to stress,[126] which activates the LC-noradrenergic system, is implicated in the over-consolidation of memories that occurs in the aftermath of trauma.[127] This over-consolidation increases the likelihood of one's developing PTSD. The amygdala is responsible for threat detection and the conditioned and unconditioned fear responses that are carried out as a response to a threat.[63]

The HPA axis is responsible for coordinating the hormonal response to stress.[63] Given the strong cortisol suppression to dexamethasone in PTSD, HPA axis abnormalities are likely predicated on strong negative feedback inhibition of cortisol, itself due to an increased sensitivity of glucocorticoid receptors.[128]

PTSD has been hypothesized to be a maladaptive learning pathway to fear response through a hypersensitive, hyperreactive, and hyperresponsive HPA axis.[129]

Low cortisol levels may predispose individuals to PTSD: Following war trauma, Swedish soldiers serving in Bosnia and Herzegovina with low pre-service salivary cortisol levels had a higher risk of reacting with PTSD symptoms, following war trauma, than soldiers with normal pre-service levels.[130] Because cortisol is normally important in restoring homeostasis after the stress response, it is thought that trauma survivors with low cortisol experience a poorly contained—that is, longer and more distressing—response, setting the stage for PTSD.

It is thought that the locus coeruleus-noradrenergic system mediates the over-consolidation of fear memory. High levels of cortisol reduce noradrenergic activity, and because people with PTSD tend to have reduced levels of cortisol, it has been proposed that individuals with PTSD cannot regulate the increased noradrenergic response to traumatic stress.[117] Intrusive memories and conditioned fear responses are thought to be a result of the response to associated triggers. Neuropeptide Y (NPY) has been reported to reduce the release of norepinephrine and has been demonstrated to have anxiolytic properties in animal models. Studies have shown that people with PTSD demonstrate reduced levels of NPY, possibly indicating their increased anxiety levels.[63]

Other studies indicate that people with PTSD have chronically low levels of serotonin, which contributes to the commonly associated behavioral symptoms such as anxiety, ruminations, irritability, aggression, suicidality, and impulsivity.[131] Serotonin also contributes to the stabilization of glucocorticoid production.

Dopamine levels in a person with PTSD can contribute to symptoms: low levels can contribute to anhedonia, apathy, impaired attention, and motor deficits; high levels can contribute to psychosis, agitation, and restlessness.[131]

Studies have also described elevated concentrations of the thyroid hormone triiodothyronine in PTSD.[132] This kind of type 2 allostatic adaptation may contribute to increased sensitivity to catecholamines and other stress mediators.

Hyperresponsiveness in the norepinephrine system can also be caused by continued exposure to high stress. Overactivation of norepinephrine receptors in the prefrontal cortex can be connected to the flashbacks and nightmares frequently experienced by those with PTSD. A decrease in other norepinephrine functions (awareness of the current environment) prevents the memory mechanisms in the brain from processing the experience, and emotions the person is experiencing during a flashback are not associated with the current environment.[131]

There is considerable controversy within the medical community regarding the neurobiology of PTSD. A 2012 review showed no clear relationship between cortisol levels and PTSD. The majority of reports indicate people with PTSD have elevated levels of corticotropin-releasing hormone, lower basal cortisol levels, and enhanced negative feedback suppression of the HPA axis by dexamethasone.[63][133]

### Neuroimmunology

Studies on the peripheral immune have found dysfunction with elevated cytokine levels and a higher risk of immune-related chronic diseases among individuals with PTSD.[134] Neuroimmune dysfunction has also been found in PTSD, raising the possibility of a suppressed central immune response due to reduced activity of microglia in the brain in response to immune challenges. Individuals with PTSD, compared to controls, have a lower increase in a marker of microglial activation (18-kDa translocator protein) following lipopolysaccharide administration.[135] This neuroimmune suppression is also associated with greater severity of anhedonic symptoms. Researchers suggest that treatments aimed at restoring neuroimmune function could be beneficial for alleviating PTSD symptoms.[135]

### Neuroanatomy

Regions of the brain associated with stress and post-traumatic stress disorder[136]

A meta-analysis of structural MRI studies found an association with reduced total brain volume, intracranial volume, and volumes of the hippocampus, insula cortex, and anterior cingulate.[137] Much of this research stems from PTSD in those exposed to the Vietnam War.[138][139]

People with PTSD have decreased brain activity in the dorsal and rostral anterior cingulate cortices and the ventromedial prefrontal cortex, areas linked to the experience and regulation of emotion.[140]

The amygdala is strongly involved in forming emotional memories, especially fear-related memories. During high stress, the hippocampus, which is associated with placing memories in the correct context of space and time and memory recall, is suppressed. According to one theory, this suppression may be the cause of the flashbacks that can affect people with PTSD. When someone with PTSD undergoes stimuli similar to the traumatic event, the body perceives the event as occurring again because the memory was never properly recorded in the person's memory.[63][141]

The amygdalocentric model of PTSD proposes that the amygdala is very much aroused and insufficiently controlled by the medial prefrontal cortex and the hippocampus, in particular during extinction.[142] This is consistent with an interpretation of PTSD as a syndrome of deficient extinction ability.[142][143]

The basolateral nucleus (BLA) of the amygdala is responsible for the comparison and development of associations between unconditioned and conditioned responses to stimuli, which results in the fear conditioning present in PTSD. The BLA activates the central nucleus (CeA) of the amygdala, which elaborates the fear response (including behavioral response to threat and elevated startle response). Descending inhibitory inputs from the medial prefrontal cortex (mPFC) regulate the transmission from the BLA to the CeA, which is hypothesized to play a role in the extinction of conditioned fear responses.[63]

While as a whole, amygdala hyperactivity is reported by meta-analysis of functional neuroimaging in PTSD, there is a large degree of heterogeneity, more so than in social anxiety disorder or phobic disorder. Comparing dorsal (roughly the CeA) and ventral (roughly the BLA) clusters, hyperactivity is more robust in the ventral cluster, while hypoactivity is evident in the dorsal cluster. The distinction may explain the blunted emotions in PTSD (via desensitization in the CeA) as well as the fear-related component.[144]

In a 2007 study, Vietnam War combat veterans with PTSD showed a 20% reduction in the volume of their hippocampus compared with veterans who did not have such symptoms.[145] This finding was not replicated in chronic PTSD patients traumatized at an air show plane crash in 1988 (Ramstein, Germany).[146]

Evidence suggests that endogenous cannabinoid levels are reduced in PTSD, particularly anandamide, and that cannabinoid receptors (CB1) are increased to compensate.[147] There appears to be a link between increased CB1 receptor availability in the amygdala and abnormal threat processing and hyperarousal, but not dysphoria, in trauma survivors.

A 2020 study found no evidence for conclusions from prior research that suggested low IQ is a risk factor for developing PTSD.[148]

## Diagnosis

NICE recommends clinicians familiarise themselves with the range of symptoms associated with functional impairment and events that are known to contribute to the development of PTSD. It is advised to ask specific questions when assessing and to consider the frequency of traumatic events experienced. Assessment should be comprehensive, including an assessment of physical, psychological, and social needs and a risk assessment.[149]

PTSD can be difficult to diagnose because of:

* the subjective nature of most of the diagnostic criteria (although this is true for many mental disorders);
* the potential for over-reporting, e.g., while seeking disability benefits, or when PTSD could be a mitigating factor at criminal sentencing[150]
* the potential for under-reporting, e.g., stigma, pride, fear that a PTSD diagnosis might preclude certain employment opportunities;
* symptom overlap with other mental disorders such as obsessive compulsive disorder and generalized anxiety disorder;[151]
* association with other mental disorders such as major depressive disorder and generalized anxiety disorder;
* substance use disorders, which often produce some of the same signs and symptoms as PTSD; and
* substance use disorders can increase vulnerability to PTSD or exacerbate PTSD symptoms or both; and
* PTSD increases the risk of developing substance use disorders.[152]
* the differential expression of symptoms culturally (specifically with respect to avoidance and numbing symptoms, distressing dreams, and somatic symptoms)[153]

### Screening

There are a number of PTSD screening instruments for adults, such as the PTSD Checklist for DSM-5 (PCL-5)[154][155] and the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5).[156] The 17 item PTSD checklist is also capable of monitoring the severity of symptoms and the response to treatment.[36]

There are also several screening and assessment instruments for use with children and adolescents. These include the Child PTSD Symptom Scale (CPSS),[157][158] Child Trauma Screening Questionnaire,[159][160] and UCLA Post-traumatic Stress Disorder Reaction Index for DSM-IV.[161][162]

In addition, there are also screening and assessment instruments for caregivers of very young children (six years of age and younger). These include the Young Child PTSD Screen,[163] the Young Child PTSD Checklist,[163] and the Diagnostic Infant and Preschool Assessment.[164]

### Assessment

Evidence-based assessment principles, including a multimethod assessment approach, form the foundation of PTSD assessment.[165][166][167]: 25 Those who conduct assessments for PTSD may use various clinician-administered interviews and instruments to provide an official PTSD diagnosis.[168] Some commonly used, reliable, and valid assessment instruments for PTSD diagnosis, in accordance with the DSM-5, include the Clinician-Administered PTSD Scale for the DSM-5 (CAPS-5), PTSD Symptom Scale Interview (PSS-I-5), and Structured Clinical Interview for DSM-5 – PTSD Module (SCID-5 PTSD Module).[169][170][171][172]

### In the DSM and ICD

PTSD was classified as an anxiety disorder in the DSM-IV, but has since been reclassified as a "trauma- and stressor-related disorder" in the DSM-5.[1] The DSM-5 diagnostic criteria for PTSD include four symptom clusters: re-experiencing, avoidance, negative alterations in cognition/mood, and alterations in arousal and reactivity.[1][4]

The International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) classifies PTSD (code F43.1) under "Reaction to severe stress, and adjustment disorders".[173] The ICD-10 criteria for PTSD include re-experiencing, avoidance, and either increased reactivity or inability to recall certain details related to the event.[173]

The ICD-11 diagnostic description for PTSD (code 6B40) contains three components or symptom groups (1) re-experiencing, (2) avoidance, and (3) heightened sense of threat.[174][175] ICD-11 no longer includes verbal thoughts about the traumatic event as a symptom.[175] There is a predicted lower rate of diagnosed PTSD using ICD-11 compared to ICD-10 or DSM-5.[175] ICD-11 also proposes identifying a distinct subgroup with Complex Post-Traumatic Stress Disorder (CPTSD; code 6B41), who have more often experienced several or sustained traumas and have greater functional impairment than those with PTSD.[175]

### Differential diagnosis

A diagnosis of PTSD requires that the person has been exposed to an extreme stressor. Any stressor can result in a diagnosis of adjustment disorder, and it is an appropriate diagnosis for a stressor and a symptom pattern that does not meet the criteria for PTSD.

The symptom pattern for acute stress disorder must occur and be resolved within four weeks of the trauma. If it lasts longer, and the symptom pattern fits the characteristics of PTSD, the diagnosis may be changed.[29]

Obsessive–compulsive disorder (OCD) may be diagnosed for intrusive thoughts that are recurring but not related to a specific traumatic event.[29]

In extreme cases of prolonged, repeated traumatization where there is no viable chance of escape, survivors may develop complex post-traumatic stress disorder.[176] This occurs as a result of layers of trauma rather than a single traumatic event, and includes additional symptomatology, such as the loss of a coherent sense of self.[177]

## Prevention

See also: Biology:Traumatic memories

Modest benefits have been seen from early access to cognitive behavioral therapy. Critical incident stress management has been suggested as a means of preventing PTSD, but subsequent studies suggest it may produce negative outcomes.[178][179] A 2019 Cochrane review did not find evidence to support the use of intervention and that "multiple session interventions may result in worse outcomes than no intervention, for some individuals."[180] The World Health Organization recommends against the use of benzodiazepines and antidepressants for acute stress (symptoms lasting less than one month).[181] Some evidence supports the use of hydrocortisone for prevention in adults, although there is limited or no evidence supporting propranolol, escitalopram, temazepam, or gabapentin.[182][183]

### Psychological debriefing

Trauma-exposed individuals often receive treatment called psychological debriefing in an effort to prevent PTSD, which consists of interviews that are meant to allow individuals to directly confront the event and share their feelings with the counselor and to help structure their memories of the event.[184] However, several meta-analyses found that psychological debriefing is unhelpful, is potentially harmful and does not reduce the future risk of developing PTSD.[36][184][185][186] This is true for both single-session debriefing and multiple session interventions.[180] As of 2017 the American Psychological Association assessed psychological debriefing as No Research Support/Treatment is Potentially Harmful.[187]

### Early intervention

Trauma-focused intervention delivered within days or weeks of the potentially traumatic event has been found to decrease PTSD symptoms.[188] Similar to psychological debriefing, the goal of early intervention is to lessen the intensity and frequency of stress symptoms, to prevent new-onset or relapsed mental disorders and further distress later in the healing process.[189]

### Risk-targeted interventions

Risk-targeted interventions are those that attempt to mitigate specific formative information or events. It can target modeling normal behaviors, instruction on a task, or giving information on the event.[190][191]

## Management

### Combination therapy

Most combination therapy (psychological and pharmacotherapy) does not seem to be more effective than psychological therapy alone,[2][17] except for the possibility of using MDMA-assisted psychotherapy, which has limited evidence for efficacy.[18][192][193]

Canada regulates limited distribution of MDMA upon application to and approval by Health Canada.[194] In Australia, it may be prescribed in the treatment of PTSD by specifically authorized psychiatrists.[195] Although once considering MDMA as a "breakthrough therapy", the FDA rejected it for treating PTSD in 2024, citing trial design and safety concerns.[192][193]

According to some reviews, MDMA-assisted psychotherapy reduces PTSD symptoms compared with control therapies and demonstrates a generally tolerable safety profile; its applicability is tempered by small sample sizes and adverse effects.[192][196][197] The possible therapeutic effects of MDMA may be overestimated due to participant unblinding and expectancy biases.[192][198][199]

In 2025, the FDA granted Breakthrough Therapy designation for methylone. It may have potential for the treatment of PTSD.[200]

### Counselling

The approaches with the strongest evidence include behavioral and cognitive-behavioral therapies such as prolonged exposure therapy,[201] cognitive processing therapy (CPT), and eye movement desensitization and reprocessing (EMDR).[202][203][204][205] There is some evidence for brief eclectic psychotherapy (BEP), narrative exposure therapy (NET), and written exposure therapy.[206][207]

A 2019 Cochrane review evaluated couples and family therapies compared to no care and individual and group therapies for the treatment of PTSD.[208] There were too few studies on couples therapies to determine if substantive benefits were derived, but preliminary RCTs suggested that couples therapies may be beneficial for reducing PTSD symptoms.[208]

A meta-analytic comparison of EMDR and CBT found both protocols indistinguishable in terms of effectiveness in treating PTSD; however, "the contribution of the eye movement component in EMDR to treatment outcome" is unclear.[209] A meta-analysis in children and adolescents also found that EMDR was as efficacious as CBT.[210]

Children with PTSD are far more likely to pursue treatment at school (because of its proximity and ease) than at a free clinic.[211]

#### Cognitive behavioral therapy

The diagram depicts how emotions, thoughts, and behaviors all influence each other. The triangle in the middle represents CBT's tenet that all humans' core beliefs can be summed up in three categories: self, others, and future.

CBT seeks to change the way a person feels and acts by changing the patterns of thinking or behavior, or both, responsible for negative emotions. Results from a 2018 systematic review found high strength of evidence that supports CBT-exposure therapy efficacious for a reduction in PTSD and depression symptoms, as well as the loss of PTSD diagnosis.[9] CBT has been proven to be an effective treatment for PTSD and is currently considered the standard of care for PTSD by the United States Department of Defense.[212][213]

In CBT, individuals learn to identify thoughts that make them feel afraid or upset and replace them with less distressing thoughts. The goal is to understand how certain thoughts about events cause PTSD-related stress.[214][215] A study assessing an online version of CBT for people with mild-to-moderate PTSD found that the online approach was as effective as, and cheaper than, the same therapy given face-to-face.[216][217] A 2021 Cochrane review assessed the provision of CBT in an Internet-based format found similar beneficial effects for Internet-based therapy as in face-to-face. However, the quality of the evidence was low due to the small number of trials reviewed.[218]

Exposure therapy is a type of cognitive behavioral therapy[219] that involves assisting trauma survivors to re-experience distressing trauma-related memories and reminders to facilitate habituation and successful emotional processing of the trauma memory. Most exposure therapy programs include both imaginal confrontation with the traumatic memories and real-life exposure to trauma reminders; this type of CBT has shown benefit in the treatment of PTSD.[220][36]

Some organizations[which?] have endorsed the need for exposure.[221][222] The U.S. Department of Veterans Affairs has been actively training mental health treatment staff in prolonged exposure therapy[223] and cognitive processing therapy[224] in an effort to better treat U.S. veterans with PTSD.

Recent research on contextually based third-generation behavior therapies suggests that they may produce results comparable to some of the better validated therapies.[225] Many of these therapy methods have a significant element of exposure[226] and have demonstrated success in treating the primary problems of PTSD and co-occurring depressive symptoms.[227]

#### Eye movement desensitization and reprocessing

Main article: Medicine:Eye movement desensitization and reprocessing

Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy developed and studied by Francine Shapiro.[228] She had noticed that, when she was thinking about disturbing memories herself, her eyes were moving rapidly. When she brought her eye movements under control while thinking, the thoughts were less distressing.[228]

In 2002, Shapiro and Maxfield published a theory of why this might work, called adaptive information processing.[229] This theory proposes that eye movement can be used to facilitate emotional processing of memories, changing the person's memory to attend to more adaptive information.[230] The therapist initiates voluntary rapid eye movements while the person focuses on memories, feelings or thoughts about a particular trauma.[56][231] The therapist uses hand movements to get the person to move their eyes backward and forward, but hand-tapping or tones can also be used.[56] EMDR closely resembles cognitive behavior therapy as it combines exposure (re-visiting the traumatic event), working on cognitive processes and relaxation/self-monitoring.[56] However, exposure by way of being asked to think about the experience rather than talk about it has been highlighted as one of the more important distinguishing elements of EMDR.[232]

Several scientific studies have evaluated the efficacy of EMDR in adults[233] as well as children and adolescents.[231] There is moderate strength of evidence to support the efficacy of EMDR "for reduction in PTSD symptoms, loss of diagnosis, and reduction in depressive symptoms" according to a 2018 systematic review update.[9]

In children and adolescents, a recent meta-analysis of randomized controlled trials found that EMDR was at least as efficacious as CBT, and superior to waitlist or placebo.[210] There was some evidence that EMDR might prevent depression.[233] Adverse effects were largely unstudied.[233] The benefits were greater for women with a history of sexual assault compared with people who had experienced other types of traumatizing events (such as accidents, physical assaults, and war).

The eye movement component of the therapy may not be critical for benefit.[56][230]

#### Interpersonal psychotherapy

Other approaches, in particular involving social supports,[234][235] may also be important. An open trial of interpersonal psychotherapy reported high rates of remission from PTSD symptoms without using exposure.[236]

### Medication

See also: Chemistry:List of investigational post-traumatic stress disorder drugs

Four antidepressants (sertraline, fluoxetine, paroxetine, and venlafaxine) have been shown to have a small to modest benefit over placebo.[20]

#### Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) may have some benefit for PTSD symptoms.[20][237][238] Tricyclic antidepressants are equally effective, but are less well tolerated.[239] Evidence provides support for a small or modest improvement with sertraline, fluoxetine, paroxetine, and venlafaxine.[20][240] Thus, these four medications are considered to be first-line medications for PTSD.[237][5] The SSRIs paroxetine and sertraline are approved by the U.S. Food and Drug Administration (FDA) approved for the treatment of PTSD.[36]

#### Benzodiazepines

Benzodiazepines are a point of contention for the treatment of PTSD due to some evidence showing a risk of worsening PTSD symptoms.[241] Some authors believe that the use of benzodiazepines is contraindicated for acute stress, as this group of drugs can cause dissociation.[242] Nevertheless, some use benzodiazepines with caution for short-term anxiety and insomnia.[243][244][245] While benzodiazepines can alleviate acute anxiety, there is no consistent evidence that they can stop the development of PTSD and may actually increase the risk of developing PTSD 2–5 times.[19] Some say that benzodiazepines should not be used in the immediate aftermath of a traumatic event as they may increase symptoms related to PTSD.[36]

Benzodiazepines may reduce the effectiveness of psychotherapeutic interventions, and there is some evidence that benzodiazepines may actually contribute to the development and chronicity of PTSD. For those who already have PTSD, benzodiazepines may worsen and prolong the course of illness, by worsening psychotherapy outcomes, and causing or exacerbating aggression, depression (including suicidality), and substance use.[19] Drawbacks include the risk of developing a benzodiazepine dependence, tolerance (i.e., short-term benefits wearing off with time), and withdrawal syndrome; additionally, individuals with PTSD (even those without a history of alcohol or drug misuse) are at an increased risk of abusing benzodiazepines.[5][246]

Due to several other treatments with greater efficacy for PTSD and fewer risks, benzodiazepines should be considered relatively contraindicated until all other treatment options are exhausted.[16][247]

Benzodiazepines also carry a risk of disinhibition (associated with suicidality) and some evidence suggests their use may delay or inhibit more definitive treatments for PTSD.[5][247][248]

Some evidence suggests that the hazards of benzodiazepines for PTSD are less than originally thought, since when antidepressants are accounted for the hazard ratio goes down significantly.[249]

#### Prazosin

Prazosin, an alpha-1 adrenergic antagonist, has been used in veterans with PTSD to reduce nightmares. Studies show variability in symptom improvement, appropriate dosages, and efficacy in this population.[250][251][28]

#### Glucocorticoids

Glucocorticoids may be useful for short-term therapy to protect against neurodegeneration caused by the extended stress response that characterizes PTSD, but long-term use may actually promote neurodegeneration.[252]

#### Cannabinoids

See also: Biology:Cannabis use and trauma

Cannabis is not recommended as a treatment for PTSD because scientific evidence does not currently exist demonstrating treatment efficacy for cannabinoids.[253][254][lower-alpha 3][255] However, use of cannabis or derived products is widespread among U.S. veterans with PTSD.[256]

The cannabinoid nabilone is sometimes used for nightmares in PTSD. Although some short-term benefit was shown, adverse effects are common, and it has not been adequately studied to determine efficacy.[257] An increasing number of states permit and have legalized the use of medical cannabis for the treatment of PTSD.[258]

### Other

#### Exercise, sport and physical activity

Physical activity can influence people's psychological[259] and physical health.[260] The U.S. National Center for PTSD recommends moderate exercise as a way to distract from disturbing emotions, build self-esteem and increase feelings of being in control again. They recommend a discussion with a doctor before starting an exercise program.[261]

#### Play therapy for children

Play is thought to help children link their inner thoughts with their outer world, connecting real experiences with abstract thought.[262] Repetitive play can also be one way a child relives traumatic events, and that can be a symptom of trauma in a child or young person.[263] Although it is commonly used, there have not been enough studies comparing outcomes in groups of children receiving and not receiving play therapy, so the effects of play therapy are not yet understood.[56][262]

#### Military programs

Many veterans of the wars in Iraq and Afghanistan have faced significant physical, emotional, and relational disruptions. In response, the United States Marine Corps has instituted programs to assist them in re-adjusting to civilian life, especially in their relationships with spouses and loved ones, to help them communicate better and understand what the other has gone through.[264] Walter Reed Army Institute of Research (WRAIR) developed the Battlemind program to assist service members avoid or ameliorate PTSD and related problems. Wounded Warrior Project partnered with the US Department of Veterans Affairs to create Warrior Care Network, a national health system of PTSD treatment centers.[265][266]

#### Nightmares

In 2020, the United States Food and Drug Administration granted marketing approval for an Apple Watch app called NightWare. The app aims to improve sleep for people suffering from PTSD-related nightmares by vibrating when it detects a nightmare in progress based on monitoring heart rate and body movement.[267]

## Epidemiology

Disability-adjusted life year rates for post-traumatic stress disorder per 100,000 inhabitants in 2004[268]

no data

< 43.5

43.5–45

45–46.5

46.5–48

48–49.5

49.5–51

51–52.5

52.5–54

54–55.5

55.5–57

57–58.5

> 58.5

There is debate over the rates of PTSD found in populations, but, despite changes in diagnosis and the criteria used to define PTSD between 1997 and 2013, epidemiological rates have not changed significantly.[269][270] Most of the current reliable data regarding the epidemiology of PTSD is based on DSM-IV criteria, as the DSM-5 was not introduced until 2013.

The United Nations' World Health Organization publishes estimates of PTSD impact for each of its member states; the latest data available are for 2004. Considering only the 25 most populated countries ranked by overall age-standardized Disability-Adjusted Life Year (DALY) rate, the top half of the ranked list is dominated by Asian/Pacific countries, the US, and Egypt.[268] Ranking the countries by the male-only or female-only rates produces much the same result, but with less meaningfulness, as the score range in the single-sex rankings is much-reduced (4 for women, 3 for men, as compared with 14 for the overall score range), suggesting that the differences between female and male rates, within each country, is what drives the distinctions between the countries.[271][272]

As of 2017, the cross-national lifetime prevalence of PTSD was 3.9%, based on a survey where 5.6% had been exposed to trauma.[273] The primary factor impacting treatment-seeking behavior, which can help to mitigate PTSD development after trauma was income, while being younger, female, and having less social status (less education, lower individual income, and being unemployed) were all factors associated with less treatment-seeking behavior.[273]

Age-standardized Disability-adjusted life year (DALY) rates for PTSD, per 100,000 inhabitants, in 25 most populous countries, ranked by overall rate (2004)  Region | Country | PTSD DALY rate,
overall[268] | PTSD DALY rate,
females[271] | PTSD DALY rate,
males[272]

|
|
|
|

Asia / Pacific | Thailand | 59 | 86 | 30
Asia / Pacific | Indonesia | 58 | 86 | 30
Asia / Pacific | Philippines | 58 | 86 | 30
Americas | USA | 58 | 86 | 30
Asia / Pacific | Bangladesh | 57 | 85 | 29
Africa | Egypt | 56 | 83 | 30
Asia / Pacific | India | 56 | 85 | 29
Asia / Pacific | Iran | 56 | 83 | 30
Asia / Pacific | Pakistan | 56 | 85 | 29
Asia / Pacific | Japan | 55 | 80 | 31
Asia / Pacific | Myanmar | 55 | 81 | 30
Europe | Turkey | 55 | 81 | 30
Asia / Pacific | Vietnam | 55 | 80 | 30
Europe | France | 54 | 80 | 28
Europe | Germany | 54 | 80 | 28
Europe | Italy | 54 | 80 | 28
Asia / Pacific | Russian Federation | 54 | 78 | 30
Europe | United Kingdom | 54 | 80 | 28
Africa | Nigeria | 53 | 76 | 29
Africa | Dem. Republ. of Congo | 52 | 76 | 28
Africa | Ethiopia | 52 | 76 | 28
Africa | South Africa | 52 | 76 | 28
Asia / Pacific | China | 51 | 76 | 28
Americas | Mexico | 46 | 60 | 30
Americas | Brazil | 45 | 60 | 30

### United States

PTSD affects about 5% of the US adult population each year.[274] The National Comorbidity Survey Replication has estimated that the lifetime prevalence of PTSD among adult Americans is 6.8%, with women (9.7%) more than twice as likely as men[131] (3.6%) to have PTSD at some point in their lives.[66] More than 60% of men and more than 60% of women experience at least one traumatic event in their life. The most frequently reported traumatic events by men are rape, combat, and childhood neglect or physical abuse. Women most frequently report instances of rape, sexual molestation, physical attack, being threatened with a weapon, and childhood physical abuse.[131] 88% of men and 79% of women with lifetime PTSD have at least one comorbid psychiatric disorder. Major depressive disorder, 48% of men and 49% of women, and lifetime alcohol use disorder or dependence, 51.9% of men and 27.9% of women, are the most common comorbid disorders.[275]

#### Military combat

The United States Department of Veterans Affairs estimates that 830,000 Vietnam War veterans had symptoms of PTSD.[276] The National Vietnam Veterans' Readjustment Study (NVVRS) found 15% of male and 9% of female Vietnam veterans had PTSD at the time of the study. The lifetime prevalence of PTSD was 31% for males and 27% for females. In a reanalysis of the NVVRS data, along with analysis of the data from the Matsunaga Vietnam Veterans Project, Schnurr, Lunney, Sengupta, and Waelde found that, contrary to the initial analysis of the NVVRS data, a large majority of Vietnam veterans had PTSD symptoms (but not the disorder itself). Four out of five reported recent symptoms when interviewed 20–25 years after Vietnam.[277]

A 2011 study from Georgia State University and San Diego State University found that rates of PTSD diagnosis increased significantly when troops were stationed in combat zones, had tours of longer than a year, experienced combat, or were injured. Military personnel serving in combat zones were 12.1 percentage points more likely to receive a PTSD diagnosis than their active-duty counterparts in non-combat zones. Those serving more than 12 months in a combat zone were 14.3 percentage points more likely to be diagnosed with PTSD than those who had served less than one year.[278]

Experiencing an enemy firefight was associated with an 18.3 percentage point increase in the probability of PTSD, while being wounded or injured in combat was associated with a 23.9 percentage point increase in the likelihood of a PTSD diagnosis. For the 2.16 million U.S. troops deployed in combat zones between 2001 and 2010, the total estimated two-year costs of treatment for combat-related PTSD are between $1.54 billion and $2.69 billion.[278]

As of 2013, rates of PTSD have been estimated at up to 20% for veterans returning from Iraq and Afghanistan.[279] As of 2013 13% of veterans returning from Iraq were unemployed.[280]

#### Human-made disasters

The September 11 attacks took the lives of nearly 3,000 people, leaving 6,000 injured.[281] First responders (police, firefighters, and emergency medical technicians), sanitation workers, and volunteers were all involved in the recovery efforts. The prevalence of probable PTSD in these highly exposed populations was estimated across several studies using in-person, telephone, and online interviews and questionnaires.[281][282][283] Overall prevalence of PTSD was highest immediately following the attacks and decreased over time. However, disparities were found among the different types of recovery workers.[281][282] The rate of probable PTSD for first responders was lowest directly after the attacks and increased from ranges of 4.8–7.8% to 7.4–16.5% between the 5–6 year follow-up and a later assessment.[281]

When comparing traditional responders to non-traditional responders (volunteers), the probable PTSD prevalence 2.5 years after the initial visit was greater in volunteers, with estimates of 11.7% and 17.2% respectively.[281] Volunteer participation in tasks atypical to the defined occupational role was a significant risk factor for PTSD.[282] Other risk factors included exposure intensity, earlier start date, duration of time spent on site, and constant, negative reminders of the trauma.[281][282]

Additional research has been performed to understand the social consequences of the September 11 attacks. Alcohol consumption was assessed in a cohort of World Trade Center workers using the cut-annoyed-guilty-eye (CAGE) questionnaire for alcohol use disorder. Almost 50% of World Trade Center workers who self-identified as alcohol users reported drinking more during the rescue efforts.[283] Nearly a quarter of these individuals reported drinking more following the recovery.[283] If determined to have probable PTSD status, the risk of developing an alcohol problem was double compared to those without psychological morbidity.[283] Social disability was also studied in this cohort as a social consequence of the September 11 attacks. Defined by the disruption of family, work, and social life, the risk of developing social disability increased 17-fold when categorized as having probable PTSD.[283]

## Anthropology

Cultural and medical anthropologists have questioned the validity of applying the diagnostic criteria of PTSD cross-culturally.[284]

Trauma (and resulting PTSD) is often experienced through the outermost limits of suffering, pain, and fear. The images and experiences relived through PTSD often defy easy description through language. Therefore, the translation of these experiences from one language to another is problematic, and the primarily Euro-American research on trauma is necessarily limited.[285]

For example, ethnopsychology studies in Nepal have found that cultural idioms and concepts related to trauma often do not translate to western terminologies: piDaa is a term that may align to trauma/suffering, but also people who suffer from piDaa are considered paagal (mad) and are subject to negative social stigma, indicating the need for culturally appropriate and carefully tailored support interventions.[286] More generally, different cultures remember traumatic experiences within different linguistic and cultural paradigms. As such, cultural and medical anthropologists have questioned the validity of applying the diagnostic criteria of PTSD cross-culturally, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III),[needs update] and constructed through the Euro-American paradigm of psychology.[284]

There remains a dearth of studies into the conceptual frameworks that surround trauma in non-Western cultures.[284] There is little evidence to suggest therapeutic benefit in synthesizing local idioms of distress into a culturally constructed disorder of the post-Vietnam era, a practice anthropologist believe contributes to category fallacy.[clarification needed][284] For many cultures, there is no single linguistic corollary to PTSD, psychological trauma being a multi-faceted concept with corresponding variances of expression.[286]

Designating the effects of trauma as an affliction of the spirit is common in many non-Western cultures, where idioms such as "soul loss" and "weak heart" indicate a preference to confer suffering to a spirit-body or heart-body diametric. These idioms reflect the emphasis that collectivist cultures place on healing trauma through familial, cultural, and religious activities while avoiding the stigma that accompanies a mind-body approach.[284] Prescribing PTSD diagnostics within these communities is ineffective and often detrimental. For trauma that extends beyond the individual, such as the effects of war, anthropologists believe applying the term "social suffering" or "cultural bereavement" to be more beneficial.[287]

Every facet of society is affected by conflict; the prolonged exposure to mass violence can lead to a 'continuous suffering' among civilians, soldiers, and bordering countries.[288] Entered into the DSM in 1980, clinicians and psychiatrists based the diagnostic criteria for PTSD around American veterans of the Vietnam War.[289] Though the DSM gets reviewed and updated regularly, it is unable to fully encompass the disorder due to its Americanization (or Westernization).[290] That is, what may be considered characteristics of PTSD in Western society may not directly translate across to other cultures around the world. Displaced people of the African country Burundi experienced symptoms of depression and anxiety, though a few symptoms specific to PTSD were noted.[291]

## Veterans

Vietnam Veterans Memorial, Washington, D.C.

### United States

See also: Benefits for US Veterans with PTSD

The United States provides a range of benefits for veterans that the VA has determined have PTSD that developed during, or as a result of, their military service. These benefits may include tax-free cash payments,[292] free or low-cost mental health treatment and other healthcare,[293] vocational rehabilitation services,[294] employment assistance,[295] and independent living support.[296][297]

### United Kingdom

In the UK, there are various charities and service organisations dedicated to aiding veterans in readjusting to civilian life. The Royal British Legion and the more recently established Help for Heroes are two of Britain's more high-profile veterans' organisations, which have actively advocated for veterans over the years. There has been some controversy that the NHS has not done enough in tackling mental health issues and is instead "dumping" veterans on charities such as Combat Stress.[298][299]

### Canada

Veterans Affairs Canada provides assistance to disabled veterans that includes rehabilitation, financial aid, job placement, healthcare, disability compensation, peer support,[300][301] and family support.[302]

## History

See also: Medicine:List of people with post-traumatic stress disorder

Aspects of PTSD in soldiers of ancient Assyria have been identified using written sources from 1300 to 600 BCE. These Assyrian soldiers would undergo a three-year rotation of combat before being allowed to return home, and were reported to have faced immense challenges in reconciling their past actions in war with their civilian lives.[303]

Connections between the actions of Viking berserkers and the hyperarousal of post-traumatic stress disorder have also been drawn.[304]

Psychiatrist Jonathan Shay has proposed that Lady Percy's soliloquy in the William Shakespeare play Henry IV, Part 1 (act 2, scene 3, lines 40–62[305]), written around 1597, represents an unusually accurate description of the symptom constellation of PTSD.[306]

Many historical wartime diagnoses such as railway spine, stress syndrome, nostalgia, soldier's heart, shell shock, battle fatigue, combat stress reaction, and traumatic war neurosis are now associated with PTSD.[307][308]

The correlations between combat and PTSD are undeniable; according to Stéphane Audoin-Rouzeau and Annette Becker, "One-tenth of mobilized American men were hospitalized for mental disturbances between 1942 and 1945, and, after thirty-five days of uninterrupted combat, 98% of them manifested psychiatric disturbances in varying degrees."[309]

The DSM-I (1952) includes a diagnosis of "gross stress reaction", which has similarities to the modern definition and understanding of PTSD.[310] Gross stress reaction is defined as a normal personality using established patterns of reaction to deal with overwhelming fear as a response to conditions of great stress.[311] The diagnosis includes language which relates the condition to combat as well as to "civilian catastrophe".[311]

Statue, Three Servicemen, Vietnam Veterans Memorial

The addition of the term to the DSM-III was greatly influenced by the experiences and conditions of U.S. military veterans of the Vietnam War.[312] In fact, much of the available published research regarding PTSD is based on studies done on veterans of the war in Vietnam.

Because of the initial overt focus on PTSD as a combat related disorder when it was first fleshed out in the years following the war in Vietnam, in 1975 Ann Wolbert Burgess and Lynda Lytle Holmstrom defined rape trauma syndrome (RTS) to draw attention to the striking similarities between the experiences of soldiers returning from war and of rape victims.[313] This paved the way for a more comprehensive understanding of the causes of PTSD.

Early in 1978, the diagnosis term "post-traumatic stress disorder" was first recommended in a working group finding presented to the Committee of Reactive Disorders.[314]

A USAF study carried out in 1979 focused on individuals (civilian and military) who had worked to recover or identify the remains of those who died in Jonestown. The bodies had been dead for several days, and a third of them had been children. The study used the term "dysphoria" to describe PTSD-like symptoms.[315]

After PTSD became an official American psychiatric diagnosis with the publication of DSM-III (1980), the number of personal injury lawsuits (tort claims) asserting the plaintiff had PTSD increased rapidly. However, triers of fact (judges and juries) often regarded the PTSD diagnostic criteria as imprecise, a view shared by legal scholars, trauma specialists, forensic psychologists, and forensic psychiatrists. The condition was termed "posttraumatic stress disorder" in the DSM-III (1980).[310][314]

Professional discussions and debates in academic journals, at conferences, and between thought leaders, led to a more clearly defined set of diagnostic criteria in DSM-IV (1994), particularly the definition of a "traumatic event".[316] The DSM-IV classified PTSD under anxiety disorders. In the ICD-10 (first used in 1994), the spelling of the condition was "post-traumatic stress disorder".[317]

In 2012, the researchers from the Grady Trauma Project highlighted the tendency people have to focus on the combat side of PTSD: "less public awareness has focused on civilian PTSD, which results from trauma exposure that is not combat related..." and "much of the research on civilian PTSD has focused on the sequelae of a single, disastrous event, such as the Oklahoma City bombing, September 11th attacks, and Hurricane Katrina".[318] Disparity in the focus of PTSD research affected the already popular perception of the exclusive interconnectedness of combat and PTSD. This is misleading when it comes to understanding the implications and extent of PTSD as a neurological disorder.

The DSM-5 (2013) created a new category called "trauma and stressor-related disorders", in which PTSD is now classified.[1]

America's 2014 National Comorbidity Survey reports that "the traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women."[66]

## Terminology

"PTSS" redirects here. It is not to be confused with Post Traumatic Slave Syndrome.

The Diagnostic and Statistical Manual of Mental Disorders does not hyphenate "post" and "traumatic", thus, the DSM-5 lists the disorder as posttraumatic stress disorder.[319] However, many scientific journal articles and other scholarly publications do hyphenate the name of the disorder, viz., "post-traumatic stress disorder".[320] Dictionaries also differ concerning the preferred spelling of the disorder with the Collins English Dictionary – Complete and Unabridged using the hyphenated spelling, and the American Heritage Dictionary of the English Language, Fifth Edition and the Random House Kernerman Webster's College Dictionary giving the non-hyphenated spelling.[321]

Some authors have used the terms "post-traumatic stress syndrome" or "post-traumatic stress symptoms" ("PTSS"),[322] or simply "post-traumatic stress" ("PTS") in the case of the U.S. Department of Defense,[323] to avoid stigma associated with the word "disorder".

The comedian George Carlin criticized the euphemism treadmill which led to progressive change of the way PTSD was referred to over the course of the 20th century, from "shell shock" in the First World War to the "battle fatigue" in the Second World War, to "operational exhaustion" in the Korean War, to the current "post-traumatic stress disorder", coined during the Vietnam War, which "added a hyphen" and which, he commented, "completely burie[s] [the pain] under jargon". He also stated that the name given to the condition has had a direct effect on the way veteran soldiers with PTSD were treated and perceived by civilian populations over time.[324] Other terms for PTSD in the English speaking world include "bossies",used in during the South African Border War.[325]

## Research

See also: Chemistry:List of investigational post-traumatic stress disorder drugs

Most knowledge regarding PTSD comes from studies in high-income countries.[326]

To recapitulate some of the neurological and neurobehavioral symptoms experienced by the veteran population of recent conflicts in Iraq and Afghanistan, researchers at the Roskamp Institute and the James A Haley Veteran's Hospital (Tampa) have developed an animal model to study the consequences of mild traumatic brain injury (mTBI) and PTSD.[327] In the laboratory, the researchers exposed mice to a repeated session of unpredictable stressor (i.e. predator odor while restrained), and physical trauma in the form of inescapable foot-shock, and this was also combined with a mTBI. In this study, PTSD animals demonstrated recall of traumatic memories, anxiety, and impaired social behavior, while animals subject to both mTBI and PTSD had a pattern of disinhibitory-like behavior. mTBI abrogated both contextual fear and impairments in social behavior seen in PTSD animals. In comparison with other animal studies,[327][328] examination of neuroendocrine and neuroimmune responses in plasma revealed a trend toward increase in corticosterone in PTSD and combination groups.

Stellate ganglion block is an experimental procedure for the treatment of PTSD.[329]

### Psychotherapy

Trauma-focused psychotherapies for PTSD (also known as "exposure-based" or "exposure" psychotherapies), such as prolonged exposure therapy (PE), eye movement desensitization and reprocessing (EMDR), and cognitive-reprocessing therapy (CPT) have the most evidence for efficacy and are recommended as first-line treatment for PTSD by almost all clinical practice guidelines.[330][331][332] Exposure-based psychotherapies demonstrate efficacy for PTSD caused by different trauma "types", such as combat, sexual-assault, or natural disasters.[330] At the same time, many trauma-focused psychotherapies evince high drop-out rates.[333]

Most systematic reviews and clinical guidelines indicate that psychotherapies for PTSD, most of which are trauma-focused therapies, are more effective than pharmacotherapy (medication),[334] although there are reviews that suggest exposure-based psychotherapies for PTSD and pharmacotherapy are equally effective.[335] Interpersonal psychotherapy shows preliminary evidence of probable efficacy, but more research is needed to reach definitive conclusions.[336]

## See also

* Childbirth-related post-traumatic stress disorder
* PTSD in children and adolescents
* Internet interventions for post-traumatic stress
* Internet-based treatments for trauma survivors
* Post-traumatic embitterment disorder
* Post-traumatic growth
* Post-traumatic stress disorder after World War II
* Post-traumatic stress disorder and substance use disorders
* Symptoms of victimization
* Trauma-informed mindfulness
* Traumatic stress
* Impact of prostitution on mental health
* Ibogaine treatment

## Notes

1. ↑ At least 1 month of symptoms for clinical diagnosis is required, while symptoms may persist from 6 months to multiple years.[1][3]
2. ↑ Acceptable variants of this term exist; see the Terminology section in this article.
3. ↑ As an example of such research, see: Bonn-Miller MO, Sisley S, Riggs P, Yazar-Klosinski B, Wang JB, Loflin MJE, et al. (2021) The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial. PLOS ONE 16(3): e0246990.

## References

1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. pp. 271–80. ISBN 978-0-89042-555-8. https://archive.org/details/diagnosticstatis0005unse/page/271.
2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 "Post-traumatic stress disorder". BMJ 351. November 2015. doi:10.1136/bmj.h6161. PMID 26611143.
3. ↑ "Post-Traumatic Stress Disorder" (in en). https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd.
4. ↑ 4.0 4.1 4.2 4.3 4.4 "Post-Traumatic Stress Disorder". February 2016. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd.
5. ↑ 5.0 5.1 5.2 5.3 5.4 "Pharmacologic alternatives to antidepressants in posttraumatic stress disorder: a systematic review". Progress in Neuro-Psychopharmacology & Biological Psychiatry 33 (2): 169–80. March 2009. doi:10.1016/j.pnpbp.2008.12.004. PMID 19141307.
6. ↑ Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association. 2013. p. 276. ISBN 978-0-89042-555-8. OCLC 830807378. https://archive.org/details/diagnosticstatis0005unse/page/276.
7. ↑ "Post-traumatic stress disorder (PTSD) – Symptoms and causes". https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967.
8. ↑ Wild, Jennifer; Duffy, Michael; Ehlers, Anke (2023). "Moving forward with the loss of a loved one: treating PTSD following traumatic bereavement with cognitive therapy". Cognitive Behaviour Therapist 16. doi:10.1017/S1754470X23000041. ISSN 1754-470X. PMID 37159811.
9. ↑ 9.0 9.1 9.2 Forman-Hoffman, Valerie; Cook Middleton, Jennifer; Feltner, Cynthia; Gaynes, Bradley N.; Palmieri Weber, Rachel; Bann, Carla; Viswanathan, Meera; Lohr, Kathleen N. et al. (2018-05-17) (in en). ﻿Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder: A Systematic Review Update﻿ (Report). Agency for Healthcare Research and Quality (AHRQ). doi:10.23970/ahrqepccer207. PMID 30204376. https://effectivehealthcare.ahrq.gov/topics/ptsd-adult-treatment-update/research-2018. Retrieved 25 August 2020.
10. ↑ "VA.gov | Veterans Affairs" (in en). https://www.ptsd.va.gov/professional/treat/specific/attachment_child.asp#:~:text=Young children may also show,irritable, aggressive, or unsafe..
11. ↑ "Current status on behavioral and biological markers of PTSD: a search for clarity in a conflicting literature". Neuroscience and Biobehavioral Reviews 37 (5): 860–895. June 2013. doi:10.1016/j.neubiorev.2013.03.024. PMID 23567521.
12. ↑ "Trauma and PTSD in the WHO World Mental Health Surveys". European Journal of Psychotraumatology 8 (sup5). 2017-10-27. doi:10.1080/20008198.2017.1353383. PMID 29075426. "As detailed in another recent WMH report, conditional risk of PTSD after trauma exposure is 4.0%, but varies significantly by trauma type. The highest conditional risk is associated with being raped (19.0%), physical abuse by a romantic partner (11.7%), being kidnapped (11.0%), and being sexually assaulted other than rape (10.5%). In terms of broader categories, the traumas associated with the highest PTSD risk are those involving intimate partner or sexual violence (11.4%), and other traumas (9.2%), with aggregate conditional risk much lower in the other broad trauma categories (2.0–5.4%) [citations omitted; emphasis added].".
13. ↑ "Main traumatic events in Europe: PTSD in the European study of the epidemiology of mental disorders survey". Journal of Traumatic Stress 21 (5): 455–462. October 2008. doi:10.1002/jts.20357. PMID 18956444. "In univariate analyses adjusted on gender, six events were found to be the most significantly associated with PTSD ( p < .001) among individuals exposed to at least one event. They were being raped (OR = 8.9), being beaten up by spouse or romantic partner (OR = 7.3), experiencing an undisclosed private event (OR = 5.5), having a child with serious illness (OR = 5.1), being beaten up by a caregiver (OR = 4.5), or being stalked (OR = 4.2)" [OR = odds ratio].".
14. ↑ "Post-traumatic stress disorder" (in en). https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder.
15. ↑ Fung, H.W. (2025). "Prevalence of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD in the general populations: A systematic review and meta-analysis". Asian Journal of Psychiatry 110. doi:10.1016/j.ajp.2025.104610. PMID 40652792.
16. ↑ 16.0 16.1 "The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis". Clinical Psychology Review 40: 184–94. August 2015. doi:10.1016/j.cpr.2015.06.008. PMID 26164548.
17. ↑ 17.0 17.1 "Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD)". The Cochrane Database of Systematic Reviews (7). July 2010. doi:10.1002/14651858.CD007316.pub2. PMID 20614457. PMC 12515543. https://eprints.qut.edu.au/84458/1/Hetrick-2010-Combined pharmacotherapy and psyc.pdf.
18. ↑ 18.0 18.1 Hoskins, Mathew D; Sinnerton, Robert; Nakamura, Anna; Underwood, Jack F G; Slater, Alan; Lewis, Catrin; Roberts, Neil P; Bisson, Jonathan I et al. (15 January 2021). "Pharmacological-assisted Psychotherapy for Post Traumatic Stress Disorder: a systematic review and meta-analysis". Eur J Psychotraumatol. 12 (1). doi:10.1080/20008198.2020.1853379. PMID 33680344.
19. ↑ 19.0 19.1 19.2 "Benzodiazepines for PTSD: A Systematic Review and Meta-Analysis". Journal of Psychiatric Practice 21 (4): 281–303. July 2015. doi:10.1097/pra.0000000000000091. PMID 26164054.
20. ↑ 20.0 20.1 20.2 20.3 "Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis". The British Journal of Psychiatry 206 (2): 93–100. February 2015. doi:10.1192/bjp.bp.114.148551. PMID 25644881. "Some drugs have a small positive impact on PTSD symptoms".
21. ↑ Handbook of Integrative Clinical Psychology, Psychiatry, and Behavioral Medicine Perspectives, Practices, and Research.. New York: Springer Pub. Co.. 2009. p. 353. ISBN 978-0-8261-1095-4. https://books.google.com/books?id=4Tkdm1vRFbUC&pg=PA353.
22. ↑ Traumatic Events and Mental Health. Cambridge University Press. 1998. p. 7.
23. ↑ Trauma and Recovery: The Aftermath of Violence – From Domestic Abuse to Political Terror. Basic Books. 2015. p. 9. ISBN 978-0-465-09873-6. https://books.google.com/books?id=ABhpCQAAQBAJ.
24. ↑ Waters, John (4 June 2015). "After War: A Conversation with Author Nancy Sherman | RealClearDefense". http://www.realcleardefense.com/articles/2015/06/05/after_war_an_interview_with_author_nancy_sherman_108023.html.
25. ↑ "15". Clinical child psychiatry (3 ed.). Chichester, West Sussex, UK: John Wiley & Sons. 2012. ISBN 978-1-119-96770-5. https://books.google.com/books?id=EL8eMEkxzkYC&pg=PT411.
26. ↑ "Finalizing PTSD in DSM-5: getting here from there and where to go next". Journal of Traumatic Stress 26 (5): 548–56. October 2013. doi:10.1002/jts.21840. PMID 24151001.
27. ↑ APA Releases Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) (5th ed.). March 2022. p. 683. https://archive.org/details/dsm-5-tr/page/n683/. Retrieved 2025-01-12. "Symptoms usually begin within the first 3 months after the trauma, although there may be a delay of months, or even years, before full criteria for the diagnosis are met. There is abundant evidence for what DSM-IV called "delayed onset" but is now called "delayed expression," with the recognition that some symptoms typically appear immediately and that the delay is in meeting full criteria."
28. ↑ 28.0 28.1 "Management of Post-Traumatic Nightmares: a Review of Pharmacologic and Nonpharmacologic Treatments Since 2013". Current Psychiatry Reports (Springer Science and Business Media LLC) 20 (12). 2018-10-11. doi:10.1007/s11920-018-0971-2. ISSN 1523-3812. PMID 30306339.
29. ↑ 29.0 29.1 29.2 American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association. ISBN 978-0-89042-061-4. https://archive.org/details/diagnosticstati00amer. ;
30. ↑ "The primary care PTSD screen (PC-PTSD): development and operating characteristics.". Primary Care Psychiatry. https://depts.washington.edu/fammed/improvingopioidcare/wp-content/uploads/sites/12/2018/02/Prins-2003.pdf.
31. ↑ 31.0 31.1 The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. New York: W.W. Norton & Company. 2000. ISBN 978-0-393-70327-6.
32. ↑ Template:Ci er 4
33. ↑ "Posttraumatic Growth as a Response to Natural Disasters in Children and Adolescents". Current Psychiatry Reports 20 (5). May 2018. doi:10.1007/s11920-018-0900-4. PMID 29766312.
34. ↑ Guay, Stéphane; Beaulieu-Prévost, Dominic; Beaudoin, Cindy; St-Jean-Trudel, Edith; Nachar, Nadim; Marchand, André; O'Connor, Kieron P. (2011-04-14). "How Do Social Interactions with a Significant Other Affect PTSD Symptoms? An Empirical Investigation with a Clinical Sample". Journal of Aggression, Maltreatment & Trauma 20 (3): 280–303. doi:10.1080/10926771.2011.562478. ISSN 1092-6771. PMID 23687440.
35. ↑ "Posttraumatic disorders following injury: an empirical and methodological review". Clinical Psychology Review 23 (4): 587–603. July 2003. doi:10.1016/S0272-7358(03)00036-9. PMID 12788111.
36. ↑ 36.0 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 "Post-Traumatic Stress Disorder". The New England Journal of Medicine 376 (25): 2459–2469. June 2017. doi:10.1056/NEJMra1612499. PMID 28636846.
37. ↑ Psychotropic drugs: fast facts (3rd ed.). New York: W.W. Norton & Company. 2002. p. 348. ISBN 978-0-393-70301-6.
38. ↑ "Alcohol and benzodiazepines generate anxiety, panic and phobias". Journal of the Royal Society of Medicine 88 (2): 73–7. February 1995. PMID 7769598.
39. ↑ "Treatment of PTSD and Substance Abuse Comorbidity". The Behavior Analyst Today 9 (1): 11–26. 2007. doi:10.1037/h0100643. http://www.baojournal.com/BAT Journal/VOL-9/BAT 9-1.pdf.
40. ↑ "A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment". HNO 67 (Suppl 1): 10–42. 2019. doi:10.1007/s00106-019-0633-7. PMID 30847513.
41. ↑ "Stress and tinnitus—from bedside to bench and back". Frontiers in Systems Neuroscience 6 (47): 47. 2022. doi:10.3389/fnsys.2012.00047. PMID 22701404.
42. ↑ Hori, Hiroaki; Kim, Yoshiharu (2019). "Inflammation and post-traumatic stress disorder" (in en). Psychiatry and Clinical Neurosciences 73 (4): 143–153. doi:10.1111/pcn.12820. ISSN 1440-1819. PMID 30653780. https://onlinelibrary.wiley.com/doi/abs/10.1111/pcn.12820.
43. ↑ "Emotion regulation difficulties in traumatized youth: a meta-analysis and conceptual review". European Child & Adolescent Psychiatry 27 (4): 527–544. April 2018. doi:10.1007/s00787-018-1105-4. PMID 29380069. https://kclpure.kcl.ac.uk/portal/files/87273928/Emotion_regulation_difficulties_in_VILLALTA_Publishedonline27January2018_GREEN_AAM.pdf.
44. ↑ "Moral injury, mental health and behavioural health outcomes: A systematic review of the literature". Clinical Psychology & Psychotherapy 29 (1): 92–110. January 2022. doi:10.1002/cpp.2607. PMID 33931926.
45. ↑ "Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers". The American Journal of Psychiatry 161 (8): 1370–6. August 2004. doi:10.1176/appi.ajp.161.8.1370. PMID 15285961.
46. ↑ Mascarelli, Amanda interview of Stanley, Ian H., Acute stress and early signs of PTSD are common in firefighters and other first responders − here's what to watch out for, The Conversation, January 17, 2025 — note link to free PTSD Coach and to National Center for PTSD
47. ↑ "Work-related post-traumatic stress disorder". Occupational Medicine 63 (3): 175–82. April 2013. doi:10.1093/occmed/kqt003. PMID 23564090.
48. ↑ "Posttraumatic stress disorder: clinical features, pathophysiology, and treatment". The American Journal of Medicine 119 (5): 383–90. May 2006. doi:10.1016/j.amjmed.2005.09.027. PMID 16651048.
49. ↑ "Trauma and Posttraumatic Stress Disorder". Massachusetts General Hospital comprehensive clinical psychiatry (Second ed.). London: Elsevier. 2016. pp. 380–392. ISBN 978-0-323-29507-9. OCLC 905232521.
50. ↑ Pérez-Sales, Pau (2016) (in en). Psychological Torture: Definition, Evaluation and Measurement. Taylor & Francis. p. 274. ISBN 978-1-317-20647-7.
51. ↑ 51.0 51.1 51.2 51.3 51.4 "Trauma and PTSD in the WHO World Mental Health Surveys". European Journal of Psychotraumatology 8 (sup5). 2017-10-27. doi:10.1080/20008198.2017.1353383. PMID 29075426.
52. ↑ National Collaborating Centre for Mental Health (UK) (2005). Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care. National Institute for Health and Clinical Excellence: Guidance. Gaskell (Royal College of Psychiatrists). NICE Clinical Guidelines, No. 26. ISBN 978-1-904671-25-1. https://www.ncbi.nlm.nih.gov/books/NBK56494/.
53. ↑ 53.0 53.1 "Prevalence of posttraumatic stress disorder among road traffic accident survivors: A PRISMA-compliant meta-analysis". Medicine 97 (3). January 2018. doi:10.1097/md.0000000000009693. PMID 29505023.
54. ↑ 54.0 54.1 "Prevalence of Posttraumatic Stress Disorder among Children and Adolescents following Road Traffic Accidents: A Meta-Analysis". Canadian Journal of Psychiatry 63 (12): 798–808. August 2018. doi:10.1177/0706743718792194. PMID 30081648.
55. ↑ "The International Society for Traumatic Stress Studies New Guidelines for the Prevention and Treatment of Posttraumatic Stress Disorder: Methodology and Development Process". Journal of Traumatic Stress 32 (4): 475–483. August 2019. doi:10.1002/jts.22421. PMID 31283056. http://orca.cf.ac.uk/120985/1/Binder3.pdf.
56. ↑ 56.0 56.1 56.2 56.3 56.4 56.5 56.6 National Collaborating Centre for Mental Health (UK) (2005). Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care. National Institute for Health and Clinical Excellence: Guidance No. 26. Gaskell (Royal College of Psychiatrists). ISBN 978-1-904671-25-1. https://www.ncbi.nlm.nih.gov/books/NBK56494/.
57. ↑ "Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis". The British Journal of Psychiatry 204 (5): 335–40. 2014. doi:10.1192/bjp.bp.113.131227. PMID 24785767. https://www.zora.uzh.ch/id/eprint/101391/1/BJP-2014-Alisic-335-40.pdf.
58. ↑ "Relation between coping and posttrauma cognitions on PTSD in a combat-trauma population". Mil Psychol 30 (2): 98–107. April 4, 2019. doi:10.1080/08995605.2017.1420980. PMID 29785065.
59. ↑ "Posttraumatic Stress Symptom Trajectories Among Children After Disaster Exposure: A Review". Journal of Traumatic Stress 30 (6): 571–582. December 2017. doi:10.1002/jts.22242. PMID 29193316.
60. ↑ "Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort". Psychological Medicine 37 (2): 181–92. February 2007. doi:10.1017/S0033291706009019. PMID 17052377.
61. ↑ "Lifetime sexual and physical victimization among male veterans with combat-related post-traumatic stress disorder". Military Medicine 170 (9): 787–90. September 2005. doi:10.7205/MILMED.170.9.787. PMID 16261985.
62. ↑ "Association between childhood trauma and catecholamine response to psychological stress in police academy recruits". Biological Psychiatry 57 (1): 27–32. January 2005. doi:10.1016/j.biopsych.2004.10.009. PMID 15607297.
63. ↑ 63.0 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 "PTSD and gene variants: new pathways and new thinking". Neuropharmacology 62 (2): 628–37. February 2012. doi:10.1016/j.neuropharm.2011.02.013. PMID 21356219.
64. ↑ Shattered Assumptions: Toward a New Psychology of Trauma. New York: Free Press. 1992.
65. ↑ "Untangling Psychiatric Comorbidity in Young Children Who Experienced Single, Repeated, or Hurricane Katrina Traumatic Events". Child and Youth Care Forum 44 (4): 475–492. 2015. doi:10.1007/s10566-014-9293-7. PMID 26213455.
66. ↑ 66.0 66.1 66.2 66.3 "Posttraumatic stress disorder in the National Comorbidity Survey". Archives of General Psychiatry 52 (12): 1048–60. December 1995. doi:10.1001/archpsyc.1995.03950240066012. PMID 7492257.
67. ↑ "Association of DSM-IV Posttraumatic Stress Disorder With Traumatic Experience Type and History in the World Health Organization World Mental Health Surveys". JAMA Psychiatry 74 (3): 270–281. March 2017. doi:10.1001/jamapsychiatry.2016.3783. PMID 28055082.
68. ↑ "Domestic violence and perinatal mental disorders: a systematic review and meta-analysis". PLOS Medicine 10 (5). 2013. doi:10.1371/journal.pmed.1001452. PMID 23723741.
69. ↑ Williams Gynecology (3rd ed.). McGraw Hill Professional. 2016. ISBN 978-0-07-184909-8.
70. ↑ "Sexual assault in women veterans: an examination of PTSD risk, health care utilization, and cost of care". Psychosomatic Medicine 66 (5): 749–56. 2004. doi:10.1097/01.psy.0000138117.58559.7b. PMID 15385701.
71. ↑ "Psychological consequences of sexual assault". Best Practice & Research. Clinical Obstetrics & Gynaecology 27 (1): 27–37. February 2013. doi:10.1016/j.bpobgyn.2012.08.015. PMID 23182852.
72. ↑ "Measuring trauma and health status in refugees: a critical review". JAMA 288 (5): 611–21. August 2002. doi:10.1001/jama.288.5.611. PMID 12150673.
73. ↑ "Forced displacement in Yugoslavia: a meta-analysis of psychological consequences and their moderators". Journal of Traumatic Stress 14 (4): 817–34. October 2001. doi:10.1023/A:1013054524810. PMID 11776427.
74. ↑ 74.0 74.1 UNESCO (2018). A Lifeline to learning: leveraging mobile technology to support education for refugees. UNESCO. ISBN 978-92-3-100262-5. https://unesdoc.unesco.org/ark:/48223/pf0000261278.
75. ↑ 75.0 75.1 "Posttraumatic stress disorder associated with unexpected death of a loved one: Cross-national findings from the world mental health surveys". Depression and Anxiety 34 (4): 315–326. April 2017. doi:10.1002/da.22579. PMID 27921352.
76. ↑ 76.0 76.1 "Cancer-Related Post-traumatic Stress". January 1980. https://www.cancer.gov/about-cancer/coping/survivorship/new-normal/ptsd-hp-pdq.
77. ↑ "Posttraumatic stress disorder after cancer diagnosis in adults: A meta-analysis". Depression and Anxiety 34 (4): 327–339. April 2017. doi:10.1002/da.22542. PMID 27466972. https://discovery.dundee.ac.uk/en/publications/04e54111-8d61-418b-b36b-62fc4b496470.
78. ↑ "Post-traumatic stress disorder and cancer". The Lancet. Psychiatry 4 (4): 330–338. April 2017. doi:10.1016/S2215-0366(17)30014-7. PMID 28109647.
79. ↑ "Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta-analytic review". PLOS ONE 7 (6). 2012. doi:10.1371/journal.pone.0038915. PMID 22745687. Bibcode: 2012PLoSO...738915E.
80. ↑ "Prevalence of PTSD in Survivors of Stroke and Transient Ischemic Attack: A Meta-Analytic Review". PLOS ONE 8 (6). 2013-06-19. doi:10.1371/journal.pone.0066435. PMID 23840467. Bibcode: 2013PLoSO...866435E.
81. ↑ "A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder". Psycho-Oncology 24 (4): 371–81. April 2015. doi:10.1002/pon.3654. PMID 25146298.
82. ↑ "Posttraumatic stress disorder in general intensive care unit survivors: a systematic review". General Hospital Psychiatry 30 (5): 421–34. September 2008. doi:10.1016/j.genhosppsych.2008.05.006. PMID 18774425.
83. ↑ "A systematic literature review exploring the prevalence of post-traumatic stress disorder and the role played by stress and traumatic stress in breast cancer diagnosis and trajectory". Breast Cancer: Targets and Therapy 9: 473–485. 2017. doi:10.2147/BCTT.S111101. PMID 28740430.
84. ↑ "Association between social support and post-traumatic stress disorder symptoms among Chinese patients with ovarian cancer: A multiple mediation model". PLOS ONE 12 (5). 2017-05-05. doi:10.1371/journal.pone.0177055. PMID 28475593. Bibcode: 2017PLoSO..1277055L.
85. ↑ "PsycNET". Health Psychology 28 (3): 379–388. 2009. doi:10.1037/a0014512. PMID 19450045. http://psycnet.apa.org/record/2009-06704-015. Retrieved 2018-09-30.
86. ↑ "A systematic review of PTSD to the experience of psychosis: prevalence and associated factors". BMC Psychiatry 21 (1). January 2021. doi:10.1186/s12888-020-02999-x. PMID 33413179.
87. ↑ "The phenomenology of traumatic reactions to psychotic illness". The Journal of Nervous and Mental Disease 185 (7): 434–441. July 1997. doi:10.1097/00005053-199707000-00003. PMID 9240361.
88. ↑ "Posttraumatic Reactions to Psychosis: A Qualitative Analysis". Frontiers in Psychiatry 8. 2017-07-19. doi:10.3389/fpsyt.2017.00129. PMID 28769826.
89. ↑ Abbey, Gareth; Thompson, Simon BN; Hickish, Tamas; Heathcote, David (2014-05-20). "A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder.". Journal of Clinical Oncology 32 (15_suppl). doi:10.1200/jco.2014.32.15_suppl.e20557. ISSN 0732-183X. http://eprints.bournemouth.ac.uk/24879/9/A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder.pdf.
90. ↑ Andrykowski, Michael A.; Cordova, Matthew J.; Studts, Jamie L.; Miller, Thomas W. (1998). "Posttraumatic stress disorder after treatment for breast cancer: Prevalence of diagnosis and use of the PTSD Checklist--Civilian Version (PCL--C) as a screening instrument.". Journal of Consulting and Clinical Psychology 66 (3): 586–590. doi:10.1037/0022-006x.66.3.586. ISSN 0022-006X. PMID 9642900.
91. ↑ Shelby, Rebecca A.; Golden-Kreutz, Deanna M.; Andersen, Barbara L. (2008-04-10). "PTSD diagnoses, subsyndromal symptoms, and comorbidities contribute to impairments for breast cancer survivors". Journal of Traumatic Stress 21 (2): 165–172. doi:10.1002/jts.20316. ISSN 0894-9867. PMID 18404636.
92. ↑ Shand, Lyndel K.; Cowlishaw, Sean; Brooker, Joanne E.; Burney, Sue; Ricciardelli, Lina A. (2014-11-12). "Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis". Psycho-Oncology 24 (6): 624–634. doi:10.1002/pon.3719. ISSN 1057-9249. PMID 25393527.
93. ↑ Smith, Sophia K.; Zimmerman, Sheryl; Williams, Christianna S.; Benecha, Habtamu; Abernethy, Amy P.; Mayer, Deborah K.; Edwards, Lloyd J.; Ganz, Patricia A. (2011-12-01). "Post-Traumatic Stress Symptoms in Long-Term Non-Hodgkin's Lymphoma Survivors: Does Time Heal?". Journal of Clinical Oncology 29 (34): 4526–4533. doi:10.1200/jco.2011.37.2631. ISSN 0732-183X. PMID 21990412.
94. ↑ Alter, Carol L.; Pelcovitz, David; Axelrod, Alan; Goldenberg, Barbara; Harris, Helene; Meyers, Barbara; Grobois, Brian; Mandel, Francine et al. (March–April 1996). "Identification of PTSD in Cancer Survivors" (in en). Psychosomatics 37 (2): 137–143. doi:10.1016/S0033-3182(96)71580-3. PMID 8742542.
95. ↑ Dimitrov, Lilia; Moschopoulou, Elisavet; Korszun, Ania (2019-04-05). "Interventions for the treatment of cancer-related traumatic stress symptoms: A systematic review of the literature". Psycho-Oncology 28 (5): 970–979. doi:10.1002/pon.5055. ISSN 1057-9249. PMID 30847978. https://qmro.qmul.ac.uk/xmlui/handle/123456789/58881.
96. ↑ 96.0 96.1 "Posttraumatic stress disorder in parents following infant death: A systematic review". Clinical Psychology Review 51: 60–74. February 2017. doi:10.1016/j.cpr.2016.10.007. PMID 27838460.
97. ↑ "Complicated grief after perinatal loss". Dialogues in Clinical Neuroscience 14 (2): 187–94. June 2012. doi:10.31887/DCNS.2012.14.2/akersting. PMID 22754291.
98. ↑ "Posttraumatic stress and posttraumatic stress disorder after termination of pregnancy and reproductive loss: a systematic review". Journal of Pregnancy 2015. 2015. doi:10.1155/2015/646345. PMID 25734016.
99. ↑ "The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework". Psychological Medicine 46 (6): 1121–34. April 2016. doi:10.1017/s0033291715002706. PMID 26878223. https://sussex.figshare.com/articles/journal_contribution/The_aetiology_of_post-traumatic_stress_following_childbirth_a_meta-analysis_and_theoretical_framework/23434271/1/files/41147231.pdf.
100. ↑ "Women's experiences of symptoms of posttraumatic stress disorder (PTSD) after traumatic childbirth: a review and critical appraisal". Archives of Women's Mental Health 18 (6): 761–71. December 2015. doi:10.1007/s00737-015-0560-x. PMID 26264506.
101. ↑ 101.0 101.1 101.2 "Posttraumatic stress following childbirth: a review". Clinical Psychology Review 26 (1): 1–16. January 2006. doi:10.1016/j.cpr.2005.07.002. PMID 16176853.
102. ↑ "Post-traumatic symptoms after childbirth: what should we offer?". Journal of Psychosomatic Obstetrics and Gynaecology 27 (2): 107–12. June 2006. doi:10.1080/01674820600714632. PMID 16808085.
103. ↑ "[Predictors of postpartum post-traumatic stress disorder in primiparous mothers"]. Journal de Gynécologie, Obstétrique et Biologie de la Reproduction 41 (6): 553–60. October 2012. doi:10.1016/j.jgyn.2012.04.010. PMID 22622194. https://hal-univ-tours.archives-ouvertes.fr/hal-02526438/file/2012_Montmasson_JGYN_VF.pdf.
104. ↑ Perinatal Mental Health: a Clinical Guide. Cumbria, England: M & K Pub. 2012. p. 26. ISBN 978-1-907830-49-5.
105. ↑ "PTSD following a natural disaster – PTSD UK" (in en-GB). https://www.ptsduk.org/what-is-ptsd/causes-of-ptsd/natural-disaster/.
106. ↑ Huang, Hsiao-Ying; Chao, Tzu-Yuan; Huang, Yi-Ting; Chen, Bo-Ku; Shih, Hsin-I (2025-01-01). "Increase in short-term and long-term stress-associated mental illness after Jiji earthquake in Taiwan: A twenty-year longitudinal population-based cohort study (1999–2019)". Journal of Affective Disorders 368: 757–769. doi:10.1016/j.jad.2024.09.099. ISSN 0165-0327. PMID 39293601.
107. ↑ Neria, Y.; Nandi, A.; Galea, S. (April 2008). "Post-traumatic stress disorder following disasters: a systematic review". Psychological Medicine 38 (4): 467–480. doi:10.1017/S0033291707001353. ISSN 0033-2917. PMID 17803838.
108. ↑ Lee, Ju-Yeon; Kim, Sung-Wan; Kim, Jae-Min (25 May 2020). "The Impact of Community Disaster Trauma: A Focus on Emerging Research of PTSD and Other Mental Health Outcomes". Chonnam Medical Journal 56 (2): 99–107. doi:10.4068/cmj.2020.56.2.99. ISSN 2233-7385. PMID 32509556.
109. ↑ Williams, Lee Ann Rawlins (2025-07-13). "When disasters fall out of the public eye, survivors continue to suffer – a rehabilitation professional explains how sustained mental health support is critical to recovery" (in en-US). http://theconversation.com/when-disasters-fall-out-of-the-public-eye-survivors-continue-to-suffer-a-rehabilitation-professional-explains-how-sustained-mental-health-support-is-critical-to-recovery-260781.
110. ↑ "Mental health in emergencies" (in en). https://www.who.int/news-room/fact-sheets/detail/mental-health-in-emergencies.
111. ↑ "A twin study of genetic and environmental contributions to liability for posttraumatic stress symptoms". Archives of General Psychiatry 50 (4): 257–264. April 1993. doi:10.1001/archpsyc.1993.01820160019002. PMID 8466386.
112. ↑ "Smaller hippocampal volume following sexual assault in women is associated with post-traumatic stress disorder". Acta Psychiatrica Scandinavica 138 (4): 312–324. October 2018. doi:10.1111/acps.12920. PMID 29952088. https://unsworks.unsw.edu.au/bitstreams/7adab476-9896-47fa-9619-3fc31f2e66d9/download.
113. ↑ Yehuda, Rachel; Lehrner, Amy (2018-09-07). "Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms" (in en). World Psychiatry 17 (3): 243–257. doi:10.1002/wps.20568. PMID 30192087.
114. ↑ Nordentoft, Merete; Albert, Nikolai (October 2017). "Early intervention services are effective and must be defended" (in en). World Psychiatry 16 (3): 272–274. doi:10.1002/wps.20452. ISSN 1723-8617. PMID 28941094.
115. ↑ Nesse, Randolph M. (May 2001). "The Smoke Detector Principle: Natural Selection and the Regulation of Defensive Responses" (in en). Annals of the New York Academy of Sciences 935 (1): 75–85. doi:10.1111/j.1749-6632.2001.tb03472.x. ISSN 0077-8923. PMID 11411177. https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.2001.tb03472.x.
116. ↑ The Secret Life of the Brain (Series), episode 4. PBS. 2001. Archived from the original on 2014-02-02. Retrieved 2014-01-29.
117. ↑ 117.0 117.1 "Post-traumatic stress disorder: facts and fiction". Current Opinion in Psychiatry 21 (1): 74–7. January 2008. doi:10.1097/YCO.0b013e3282f269ee. PMID 18281844.
118. ↑ "Effects of trauma exposure on the cortisol response to dexamethasone administration in PTSD and major depressive disorder". Psychoneuroendocrinology 29 (3): 389–404. April 2004. doi:10.1016/S0306-4530(03)00052-0. PMID 14644068.
119. ↑ "The cortisol and glucocorticoid receptor response to low dose dexamethasone administration in aging combat veterans and holocaust survivors with and without posttraumatic stress disorder". Biological Psychiatry 52 (5): 393–403. September 2002. doi:10.1016/S0006-3223(02)01357-4. PMID 12242055.
120. ↑ "The potential role of hypocortisolism in the pathophysiology of stress-related bodily disorders". Psychoneuroendocrinology 25 (1): 1–35. January 2000. doi:10.1016/S0306-4530(99)00035-9. PMID 10633533.
121. ↑ "Elevation of urinary norepinephrine/cortisol ratio in posttraumatic stress disorder". The Journal of Nervous and Mental Disease 176 (8): 498–502. August 1988. doi:10.1097/00005053-198808000-00008. PMID 3404142.
122. ↑ "Coping style, trait anxiety and cortisol reactivity during mental stress". Journal of Psychosomatic Research 35 (2–3): 141–7. 1991. doi:10.1016/0022-3999(91)90068-Y. PMID 2046048.
123. ↑ "CSF norepinephrine concentrations in posttraumatic stress disorder". The American Journal of Psychiatry 158 (8): 1227–30. August 2001. doi:10.1176/appi.ajp.158.8.1227. PMID 11481155.
124. ↑ "Corticotropin-releasing factor in posttraumatic stress disorder (PTSD) with secondary psychotic symptoms, nonpsychotic PTSD, and healthy control subjects". Biological Psychiatry 54 (12): 1382–8. December 2003. doi:10.1016/S0006-3223(03)00571-7. PMID 14675802.
125. ↑ "Elevated plasma corticotrophin-releasing hormone levels in veterans with posttraumatic stress disorder". Stress Hormones and Post Traumatic Stress Disorder Basic Studies and Clinical Perspectives. Progress in Brain Research. 167. 2008. pp. 287–91. doi:10.1016/S0079-6123(07)67025-3. ISBN 978-0-444-53140-7.
126. ↑ "Stress risk factors and stress-related pathology: neuroplasticity, epigenetics and endophenotypes". Stress 14 (5): 481–97. September 2011. doi:10.3109/10253890.2011.604751. PMID 21848436.
127. ↑ "Post-traumatic stress disorder, hormones, and memory". Biological Psychiatry 26 (3): 221–3. July 1989. doi:10.1016/0006-3223(89)90033-4. PMID 2545287.
128. ↑ "Biology of posttraumatic stress disorder". The Journal of Clinical Psychiatry. 62 62 (Suppl 17): 41–46. 2001. PMID 11495096.
129. ↑ "Clinical relevance of biologic findings in PTSD". The Psychiatric Quarterly 73 (2): 123–33. 2002. doi:10.1023/A:1015055711424. PMID 12025720.
130. ↑ "Salivary cortisol, posttraumatic stress symptoms, and general health in the acute phase and during 9-month follow-up". Biological Psychiatry 50 (12): 986–93. December 2001. doi:10.1016/S0006-3223(01)01253-7. PMID 11750895.
131. ↑ 131.0 131.1 131.2 131.3 131.4 "The neurobiology of PTSD: implications for nurses". Journal of Psychosocial Nursing and Mental Health Services 43 (6): 40–7. June 2005. doi:10.3928/02793695-20050601-09. PMID 16018133.
132. ↑ "Thyroid Allostasis-Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming". Frontiers in Endocrinology 8. 20 July 2017. doi:10.3389/fendo.2017.00163. PMID 28775711.
133. ↑ "Basal and dexamethasone suppressed salivary cortisol concentrations in a community sample of patients with posttraumatic stress disorder". Biological Psychiatry 55 (9): 940–5. May 2004. doi:10.1016/j.biopsych.2003.12.021. PMID 15110738.
134. ↑ Katrinli, Seyma; Oliveira, Nayara C. S.; Felger, Jennifer C.; Michopoulos, Vasiliki; Smith, Alicia K. (2022-08-04). "The role of the immune system in posttraumatic stress disorder". Translational Psychiatry 12 (1): 313. doi:10.1038/s41398-022-02094-7. ISSN 2158-3188. PMID 35927237.
135. ↑ 135.0 135.1 Bonomi, Robin; Hillmer, Ansel T.; Woodcock, Eric; Bhatt, Shivani; Rusowicz, Aleksandra; Angarita, Gustavo A.; Carson, Richard E.; Davis, Margaret T. et al. (2024-08-27). "Microglia-mediated neuroimmune suppression in PTSD is associated with anhedonia". Proceedings of the National Academy of Sciences 121 (35). doi:10.1073/pnas.2406005121. ISSN 0027-8424. PMID 39172786. Bibcode: 2024PNAS..12106005B.
136. ↑ "NIMH · Post Traumatic Stress Disorder Research Fact Sheet". National Institutes of Health. http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-research-fact-sheet/index.shtml.
137. ↑ "Meta-Analysis of 89 Structural MRI Studies in Posttraumatic Stress Disorder and Comparison With Major Depressive Disorder". The American Journal of Psychiatry 175 (10): 989–998. July 2018. doi:10.1176/appi.ajp.2018.17111199. PMID 30021460.
138. ↑ "The functional neuroanatomy of PTSD: A critical review". Stress Hormones and Post Traumatic Stress Disorder Basic Studies and Clinical Perspectives. Progress in Brain Research. 167. 2008. pp. 151–69. doi:10.1016/S0079-6123(07)67011-3. ISBN 978-0-444-53140-7.
139. ↑ "Functional neuroimaging studies of post-traumatic stress disorder". Expert Review of Neurotherapeutics 11 (2): 275–85. February 2011. doi:10.1586/ern.10.198. PMID 21306214.
140. ↑ "Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia". The American Journal of Psychiatry 164 (10): 1476–88. October 2007. doi:10.1176/appi.ajp.2007.07030504. PMID 17898336.
141. ↑ "Posttraumatic stress disorder and the nature of trauma". Dialogues in Clinical Neuroscience 2 (1): 7–22. March 2000. doi:10.31887/DCNS.2000.2.1/bvdkolk. PMID 22034447.
142. ↑ 142.0 142.1 "Neurobiological basis of failure to recall extinction memory in posttraumatic stress disorder". Biological Psychiatry 66 (12): 1075–82. December 2009. doi:10.1016/j.biopsych.2009.06.026. PMID 19748076.
143. ↑ "Imbalance of approach and avoidance: the yin and yang of anxiety disorders". Biological Psychiatry 66 (12): 1072–4. December 2009. doi:10.1016/j.biopsych.2009.09.023. PMID 19944792.
144. ↑ "Functional Neurocircuitry and Neuroimaging Studies of Anxiety Disorders". Neurobiology of Mental Illness (5th ed.). Oxford University Press.
145. ↑ Physiology of Behavior (9th ed.). Pearson Education. 2007.
146. ↑ "Hippocampal volume in chronic posttraumatic stress disorder (PTSD): MRI study using two different evaluation methods". Journal of Affective Disorders 94 (1–3): 121–6. August 2006. doi:10.1016/j.jad.2006.03.010. PMID 16701903. http://dbm.neuro.uni-jena.de/pdf-files/Jatzko-JAD06.pdf.
147. ↑ "Translational evidence for a role of endocannabinoids in the etiology and treatment of posttraumatic stress disorder". Psychoneuroendocrinology 51: 577–84. January 2015. doi:10.1016/j.psyneuen.2014.10.012. PMID 25456347.
148. ↑ "Relationship between intelligence and posttraumatic stress disorder in veterans" (in en). Intelligence 82. September 2020. doi:10.1016/j.intell.2020.101472. ISSN 0160-2896.
149. ↑ "Overview | Post-traumatic stress disorder | Guidance | NICE". 2018-12-05. https://www.nice.org.uk/guidance/ng116.
150. ↑ "Fake Posttraumatic Stress Disorder (PTSD) Costs Real Money". The Inquisitive Mind (de) 4 (36). 2018. https://www.in-mind.org/article/fake-posttraumatic-stress-disorder-ptsd-costs-real-money. Retrieved 2021-09-30.
151. ↑ DSM-5® Handbook of Differential Diagnosis. American Psychiatric Pub. 2013. p. 225. ISBN 978-1-58562-998-5. https://books.google.com/books?id=haOvBAAAQBAJ&pg=PA225.
152. ↑ Brady, Kathleen (October 2004). "Substance Abuse and Posttraumatic Stress Disorder". Current Directions in Psychological Science 13 (5): 206–209. doi:10.1111/j.0963-7214.2004.00309.x.
153. ↑ "Trauma- and Stressor-Related Disorders". Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. 2013-05-22. doi:10.1176/appi.books.9780890425596.dsm07. ISBN 978-0-89042-555-8. https://archive.org/details/diagnosticstatis0005unse.
154. ↑ "PTSD Checklist for DSM-5 (PCL-5)". 11 May 2017. https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp.
155. ↑ "The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation". Journal of Traumatic Stress 28 (6): 489–98. December 2015. doi:10.1002/jts.22059. PMID 26606250.
156. ↑ "Primary Care PTSD Screen for DSM-5 (PC-PTSD-5)". 7 April 2017. https://www.ptsd.va.gov/professional/assessment/DSM_5_Validated_Measures.asp.
157. ↑ "Child PTSD Symptom Scale". http://www.istss.org/assessing-trauma/child-ptsd-symptom-scale.aspx.
158. ↑ "The child PTSD Symptom Scale: a preliminary examination of its psychometric properties". Journal of Clinical Child Psychology 30 (3): 376–84. September 2001. doi:10.1207/S15374424JCCP3003_9. PMID 11501254.
159. ↑ "Child Trauma Screening Questionnaire". 5 Sep 2013. http://www.nctsnet.org/content/child-trauma-screening-questionnaire.
160. ↑ "Screening for posttraumatic stress disorder in children after accidental injury". Pediatrics 118 (3): 1002–9. September 2006. doi:10.1542/peds.2006-0406. PMID 16950991.
161. ↑ "UCLA Posttraumatic Stress Disorder Reaction Index". http://www.istss.org/assessing-trauma/ucla-posttraumatic-stress-disorder-reaction-index.aspx.
162. ↑ "Psychometric properties of the UCLA PTSD reaction index. part II: investigating factor structure findings in a national clinic-referred youth sample". Journal of Traumatic Stress 26 (1): 10–8. February 2013. doi:10.1002/jts.21755. PMID 23417874.
163. ↑ 163.0 163.1 "Young Child PTSD Screen". Tulane University. https://medicine.tulane.edu/departments/psychiatry/research/dr-scheeringas-lab/manuals-measures-trainings.
164. ↑ "The reliability and criterion validity of the Diagnostic Infant and Preschool Assessment: a new diagnostic instrument for young children". Child Psychiatry and Human Development 41 (3): 299–312. June 2010. doi:10.1007/s10578-009-0169-2. PMID 20052532.
165. ↑ "Evolving DSM Diagnostic Criteria for PTSD: Relevance for Assessment and Treatment". Current Treatment Options in Psychiatry 2 (1): 86–98. 2015. doi:10.1007/s40501-015-0032-y. "... the use of a multi-measure approach eliminates the bias associated with any given instrument ....".
166. ↑ "Common Data Elements in the Assessment of Military-Related PTSD Research Applied in the Consortium to Alleviate PTSD". Military Medicine 184 (5–6): e218–e226. May 2019. doi:10.1093/milmed/usy226. PMID 30252077.
167. ↑ "Assessment and Diagnosis of Adults". Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies (2nd ed.). New York: Guilford. 2009. pp. 23–61. ""Thus, ample resources are now available to conduct psychometrically sound assessments of trauma survivors in any context, and it is no longer defensible for clinicians to do otherwise."
168. ↑ "Posttraumatic Stress Disorder in DSM-5: New Criteria, New Measures, and Implications for Assessment". Psychological Injury and Law 7 (2): 93–107. 2014. doi:10.1007/s12207-014-9191-1.
169. ↑ "The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in military veterans". Psychological Assessment 30 (3): 383–395. March 2018. doi:10.1037/pas0000486. PMID 28493729.
170. ↑ "The Psychometric Properties of the Post-Traumatic Stress Disorder Symptom Scale–Interview Based on DSM-5, in Military Personnel Participated in Warfare". Iranian Journal of War & Public Health 12 (2): 115–124. 2020. doi:10.29252/ijwph.12.2.115.
171. ↑ "Comparison of the PTSD Symptom Scale-Interview Version and the Clinician-Administered PTSD scale". Journal of Traumatic Stress 13 (2): 181–191. April 2000. doi:10.1023/A:1007781909213. PMID 10838669.
172. ↑ Structured Clinical Interview for DSM-5 Disorders, Clinician Version (SCID-5-CV). Arlington, VA: American Psychiatric Association. 2016. ISBN 978-88-6030-885-6.
173. ↑ 173.0 173.1 "The ICD-10 Classification of Mental and Behavioural Disorders". World Health Organization. pp. 120–121. https://www.who.int/classifications/icd/en/bluebook.pdf.
174. ↑ "WHO releases new International Classification of Diseases (ICD 11)". World Health Organization. https://www.who.int/news-room/detail/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11).
175. ↑ 175.0 175.1 175.2 175.3 "A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD". Clinical Psychology Review 58: 1–15. December 2017. doi:10.1016/j.cpr.2017.09.001. PMID 29029837. http://mural.maynoothuniversity.ie/11577/1/Hyland_Review_2017.pdf.
176. ↑ "Complex PTSD: A syndrome in survivors of prolonged and repeated trauma". Journal of Traumatic Stress 5 (3): 377–391. July 1992. doi:10.1007/BF00977235.
177. ↑ Trauma and Recovery (2nd ed.). New York: Basic Books. 1997. pp. 119–122. ISBN 978-0-465-08730-3. https://archive.org/details/traumarecovery00herm_0/page/119.
178. ↑ "Disaster-related post-traumatic stress in police officers: A field study of the impact of debriefing". Stress Medicine 14 (3): 143–8. 1998. doi:10.1002/(SICI)1099-1700(199807)14:3<143::AID-SMI770>3.0.CO;2-S.
179. ↑ "Psychological debriefing for road traffic accident victims. Three-year follow-up of a randomised controlled trial". The British Journal of Psychiatry 176 (6): 589–93. June 2000. doi:10.1192/bjp.176.6.589. PMID 10974967.
180. ↑ 180.0 180.1 "Multiple session early psychological interventions for the prevention of post-traumatic stress disorder". The Cochrane Database of Systematic Reviews 2019 (8). August 2019. doi:10.1002/14651858.CD006869.pub3. PMID 31425615.
181. ↑ Assessment and Management of Conditions Specifically Related to Stress. Geneva: World Health Organization. 2013. ISBN 978-92-4-150593-2. http://apps.who.int/iris/bitstream/10665/85623/1/9789241505932_eng.pdf. Retrieved 2014-01-29.
182. ↑ "Pharmacological interventions for preventing post-traumatic stress disorder (PTSD)". The Cochrane Database of Systematic Reviews 2014 (7). July 2014. doi:10.1002/14651858.CD006239.pub2. PMID 25001071.
183. ↑ Bertolini, Federico; Robertson, Lindsay; Bisson, Jonathan I; Meader, Nicholas; Churchill, Rachel; Ostuzzi, Giovanni; Stein, Dan J; Williams, Taryn et al. (2022-02-10). Cochrane Common Mental Disorders Group. ed. "Early pharmacological interventions for universal prevention of post-traumatic stress disorder (PTSD)" (in en). Cochrane Database of Systematic Reviews 2022 (2). doi:10.1002/14651858.CD013443.pub2. PMID 35141873.
184. ↑ 184.0 184.1 "Discussion". Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma. Agency for Healthcare Research and Quality (US). 2013. https://www.ncbi.nlm.nih.gov/books/NBK133347/.
185. ↑ "A critical analysis of approaches to targeted PTSD prevention: current status and theoretically derived future directions". Behavior Modification 31 (1): 80–116. January 2007. doi:10.1177/0145445506295057. PMID 17179532.
186. ↑ "Psychological debriefing for preventing post traumatic stress disorder (PTSD)". The Cochrane Database of Systematic Reviews (2). 2002. doi:10.1002/14651858.CD000560. PMID 12076399.
187. ↑ "Psychological Debriefing for Post-Traumatic Stress Disorder". Society of Clinical Psychology: Division 12 of The American Psychological Association. 19 August 2014. https://www.div12.org/psychological-treatments/treatments/psychological-debriefing-for-post-traumatic-stress-disorder/.
188. ↑ "An Evidence-Based Review of Early Intervention and Prevention of Posttraumatic Stress Disorder". Community Mental Health Journal 53 (2): 183–201. February 2017. doi:10.1007/s10597-016-0047-x. PMID 27470261.
189. ↑ "Early intervention for trauma and loss: overview and working care model". European Journal of Psychotraumatology 6 (1). 2015-12-01. doi:10.3402/ejpt.v6.28543. PMID 26073207.
190. ↑ "Mental health following traumatic physical injury: an integrative literature review". Injury 44 (11): 1383–90. November 2013. doi:10.1016/j.injury.2012.02.015. PMID 22409991.
191. ↑ "Posttraumatic stress following pediatric injury: update on diagnosis, risk factors, and intervention". JAMA Pediatrics 167 (12): 1158–65. December 2013. doi:10.1001/jamapediatrics.2013.2741. PMID 24100470.
192. ↑ 192.0 192.1 192.2 192.3 "FDA rejected MDMA-assisted PTSD therapy. Other psychedelics firms intend to avoid that fate". Science Advisor (American Association for the Advancement of Science). 2024-08-12. doi:10.1126/science.zhveq6h. https://www.science.org/content/article/fda-rejected-mdma-assisted-ptsd-therapy-other-psychedelics-firms-intend-avoid-fate.
193. ↑ 193.0 193.1 "F.D.A. Declines to Approve MDMA Therapy, Seeking More Study". The New York Times. 9 August 2025. https://www.nytimes.com/2024/08/09/health/fda-mdma-ptsd-delay.html.
194. ↑ "Subsection 56(1) class exemption for practitioners, agents, pharmacists, persons in charge of a hospital, hospital employees, and licensed dealers to conduct activities with psilocybin and MDMA in relation to a special access program authorization". Health Canada. 2022-01-05. https://www.canada.ca/en/health-canada/services/health-concerns/controlled-substances-precursor-chemicals/policy-regulations/policy-documents/subsection-56-1-class-exemption-conducting-activities-psilocybin-mdma-special-access-program-authorization.html.
195. ↑ "Change to classification of psilocybin and MDMA to enable prescribing by authorised psychiatrists". 3 February 2023. https://www.tga.gov.au/news/media-releases/change-classification-psilocybin-and-mdma-enable-prescribing-authorised-psychiatrists.
196. ↑ Hoskins, Mathew D; Sinnerton, Robert; Nakamura, Anna; Underwood, Jack F G; Slater, Alan; Lewis, Catrin; Roberts, Neil P; Bisson, Jonathan I et al. (15 January 2021). "Pharmacological-assisted Psychotherapy for Post Traumatic Stress Disorder: a systematic review and meta-analysis". European Journal of Psychotraumatology 12 (1). doi:10.1080/20008198.2020.1853379. PMID 33680344.
197. ↑ Yang, Jianhua; Wang, Ni; Luo, Wulin; Gao, Junwei (2024-09-01). "The efficacy and safety of MDMA-assisted psychotherapy for treatment of posttraumatic stress disorder: A systematic review and meta-analysis from randomized controlled trials". Psychiatry Research 339. doi:10.1016/j.psychres.2024.116043. ISSN 0165-1781. PMID 38896930. https://www.sciencedirect.com/science/article/pii/S0165178124003287.
198. ↑ "Blinding and expectancy confounds in psychedelic randomized controlled trials". Expert Review of Clinical Pharmacology 14 (9): 1133–1152. September 2021. doi:10.1080/17512433.2021.1933434. PMID 34038314.
199. ↑ "Caution at psychiatry's psychedelic frontier". Nature Medicine 27 (10): 1687–1688. October 2021. doi:10.1038/s41591-021-01524-1. PMID 34635858.
200. ↑ Warner-Schmidt, Jennifer; Stogniew, Martin; Mandell, Blake; Kelmendi, Benjamin (2025-08-23). "Methylone promotes neurite outgrowth and has long-lasting effects on fear extinction learning" (in en). Neuropsychopharmacology 51 (3): 631–640. doi:10.1038/s41386-025-02206-z. ISSN 1740-634X. https://www.nature.com/articles/s41386-025-02206-z.
201. ↑ "A meta-analytic review of prolonged exposure for posttraumatic stress disorder". Clinical Psychology Review 30 (6): 635–41. August 2010. doi:10.1016/j.cpr.2010.04.007. PMID 20546985.
202. ↑ Guideline Development Panel for the Treatment of PTSD in Adults (2017) (PDF). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. Washington, D.C.: American Psychological Association. pp. ES–2. http://www.apa.org/ptsd-guideline/.
203. ↑ "A meta-analysis of the contribution of eye movements in processing emotional memories". Journal of Behavior Therapy and Experimental Psychiatry 44 (2): 231–9. June 2013. doi:10.1016/j.jbtep.2012.11.001. PMID 23266601. http://researchrepository.murdoch.edu.au/id/eprint/13100/.
204. ↑ Advances in the Treatment of Posttraumatic Stress Disorder: Cognitive-behavioral perspectives. New York: Springer. 2004. pp. 267–313.
205. ↑ Forman-Hoffman, Valerie; Cook Middleton, Jennifer; Feltner, Cynthia; Gaynes, Bradley N.; Palmieri Weber, Rachel; Bann, Carla; Viswanathan, Meera; Lohr, Kathleen N. et al. (2018-05-17). ﻿Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder: A Systematic Review Update﻿ (Report). Agency for Healthcare Research and Quality (AHRQ). doi:10.23970/ahrqepccer207. https://effectivehealthcare.ahrq.gov/topics/ptsd-adult-treatment-update/research-2018. Retrieved 25 August 2020.
206. ↑ (in en) Written exposure therapy for PTSD: A brief treatment approach for mental health professionals. Washington: American Psychological Association. 2019. doi:10.1037/0000139-001. ISBN 978-1-4338-3013-6. http://content.apa.org/books/16117-007. Retrieved 2022-02-13.
207. ↑ VA/DOD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. United States Department of Veterans Affairs. 2017. pp. 46–47. https://www.healthquality.va.gov/guidelines/MH/ptsd/VADoDPTSDCPGFinal012418.pdf. Retrieved 14 November 2018.
208. ↑ 208.0 208.1 "Couple and family therapies for post-traumatic stress disorder (PTSD)". The Cochrane Database of Systematic Reviews 2019 (12). December 2019. doi:10.1002/14651858.CD011257.pub2. PMID 31797352.
209. ↑ "Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study". Psychological Medicine 36 (11): 1515–22. November 2006. doi:10.1017/S0033291706007963. PMID 16740177.
210. ↑ 210.0 210.1 "Efficacy of Eye Movement Desensitization and Reprocessing in Children and Adolescent with Post-traumatic Stress Disorder: A Meta-Analysis of Randomized Controlled Trials". Frontiers in Psychology 8. 2017. doi:10.3389/fpsyg.2017.01750. PMID 29066991.
211. ↑ "School-based intervention programs for PTSD symptoms: a review and meta-analysis". Journal of Traumatic Stress 24 (2): 155–65. April 2011. doi:10.1002/jts.20622. PMID 21425191.
212. ↑ "Treatment of PTSD – PTSD: National Center for PTSD". U.S. Department of Veterans Affairs. May 26, 2016. http://www.ptsd.va.gov/public/treatment/therapy-med/treatment-ptsd.asp.
213. ↑ "PTSD Treatment Options". Defense Centers of Excellence. November 23, 2016. http://dcoe.mil/PsychologicalHealth/About_PTSD/Treatment_Options.aspx.
214. ↑ "Cognitive Behavioral Therapy (CBT) for Treatment of PTSD". American Psychiatric Association. http://www.apa.org/ptsd-guideline/treatments/cognitive-behavioral-therapy.aspx.
215. ↑ "Treatment of PTSD – PTSD". National Center for PTSD. https://www.ptsd.va.gov/public/treatment/therapy-med/treatment-ptsd.asp.
216. ↑ "Online CBT for post-traumatic stress disorder is as effective as face-to-face therapy". NIHR Evidence. 27 January 2023. doi:10.3310/nihrevidence_56507. https://evidence.nihr.ac.uk/alert/online-cbt-for-ptsd-is-as-effective-as-face-to-face-therapy/.
217. ↑ "Guided, internet based, cognitive behavioural therapy for post-traumatic stress disorder: pragmatic, multicentre, randomised controlled non-inferiority trial (RAPID)". BMJ 377. June 2022. doi:10.1136/bmj-2021-069405. PMID 35710124.
218. ↑ "Internet-based cognitive and behavioural therapies for post-traumatic stress disorder (PTSD) in adults". The Cochrane Database of Systematic Reviews 2021 (5). May 2021. doi:10.1002/14651858.CD011710.pub3. PMID 34015141.
219. ↑ "What Is Exposure Therapy?". Psych Central.com. Psychcentral.com. 2016-05-17. http://psychcentral.com/lib/2009/what-is-exposure-therapy/.
220. ↑ McLean, Carmen P.; Levy, Hannah C.; Miller, Madeleine L.; Tolin, David F. (February 2022). "Exposure therapy for PTSD: A meta-analysis". Clinical Psychology Review 91. doi:10.1016/j.cpr.2021.102115. PMID 34954460.
221. ↑ "Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder". The American Journal of Psychiatry 161 (11 Suppl): 3–31. November 2004. PMID 15617511.
222. ↑ Committee on Treatment of Posttraumatic Stress Disorder, Institute of Medicine: Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence. Washington, D.C.: National Academies Press. 2008. ISBN 978-0-309-10926-0.
223. ↑ "Prolonged Exposure Therapy". U.S. Department of Veteran Affairs. 2009-09-29. http://www.ptsd.va.gov/public/pages/prolonged-exposure-therapy.asp.
224. ↑ "Dissemination of evidence-based psychological treatments for posttraumatic stress disorder in the Veterans Health Administration". Journal of Traumatic Stress 23 (6): 663–73. December 2010. doi:10.1002/jts.20588. PMID 21171126.
225. ↑ "Contextual Behavior Therapies in the Treatment of PTSD: A Review". International Journal of Behavioral Consultation and Therapy 1 (3): 223–228. 2005. doi:10.1037/h0100747. http://www.uwm.edu/~jkanter/pdf/publication/IJBCT-1-3.pdf.
226. ↑ "Behavioral Interventions for Trauma and Posttraumatic Stress Disorder". International Journal of Behavioral Consultation and Therapy 3 (2): 166–175. 2007. doi:10.1037/h0100797. http://eric.ed.gov/ERICWebPortal/contentdelivery/servlet/ERICServlet?accno=EJ801196.
227. ↑ "Behavioral Activation in the Treatment of Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder". International Journal of Behavioral Consultation and Therapy 5 (2): 330–339. 2009. doi:10.1037/h0100892. http://www.thefreelibrary.com/Behavioral+activation+in+the+treatment+of+comorbid+posttraumatic...-a0221920130.
228. ↑ 228.0 228.1 "Efficacy of the eye movement desensitization procedure in the treatment of traumatic memories". Journal of Traumatic Stress 2 (2): 199–223. April 1989. doi:10.1002/jts.2490020207.
229. ↑ "Eye Movement Desensitization and Reprocessing (EMDR): information processing in the treatment of trauma". Journal of Clinical Psychology 58 (8): 933–46. August 2002. doi:10.1002/jclp.10068. PMID 12115716.
230. ↑ 230.0 230.1 The Management of Post-Traumatic Stress Working Group (2010). "VA/DoD clinical practice guideline for management of post-traumatic stress". Department of Veterans Affairs, Department of Defense. p. Version 2.0. http://www.healthquality.va.gov/Post_Traumatic_Stress_Disorder_PTSD.asp.
231. ↑ 231.0 231.1 "Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents". The Cochrane Database of Systematic Reviews 2012 (12). December 2012. doi:10.1002/14651858.CD006726.pub2. PMID 23235632.
232. ↑ "What is the role of eye movements in eye movement desensitization and reprocessing (EMDR) for post-traumatic stress disorder (PTSD)? a review". Behavioural and Cognitive Psychotherapy 41 (3): 290–300. May 2013. doi:10.1017/S1352465812000793. PMID 23102050.
233. ↑ 233.0 233.1 233.2 Psychological and pharmacological treatments for adults with posttraumatic stress disorder (PTSD). Comparative Effectiveness Reviews No. 92. Rockville, MD: Agency for Healthcare Research and Quality. April 2013. https://www.ncbi.nlm.nih.gov/books/NBK137702/.
234. ↑ "Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults". Journal of Consulting and Clinical Psychology 68 (5): 748–66. October 2000. doi:10.1037/0022-006X.68.5.748. PMID 11068961. http://content.apa.org/journals/ccp/68/5/748.
235. ↑ "Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis". Psychological Bulletin 129 (1): 52–73. January 2003. doi:10.1037/0033-2909.129.1.52. PMID 12555794. Bibcode: 2003PsycB.129...52O. http://content.apa.org/journals/bul/129/1/52.
236. ↑ "A pilot study of interpersonal psychotherapy for posttraumatic stress disorder". The American Journal of Psychiatry 162 (1): 181–3. January 2005. doi:10.1176/appi.ajp.162.1.181. PMID 15625219.
237. ↑ 237.0 237.1 "Pharmacotherapy for posttraumatic stress disorder: review with clinical applications". Journal of Rehabilitation Research and Development 49 (5): 703–715. 2012. doi:10.1682/JRRD.2011.09.0183. PMID 23015581. "While evidence-based, trauma-focused psychotherapy is the preferred treatment for PTSD, pharmacotherapy is also an important treatment option. First-line pharmacotherapy agents include selective serotonin reuptake inhibitors and the selective serotonin-norepinephrine reuptake inhibitor venlafaxine.".
238. ↑ "Pharmacotherapy for post traumatic stress disorder (PTSD)". The Cochrane Database of Systematic Reviews 2022 (3). March 2022. doi:10.1002/14651858.CD002795.pub3. PMID 35234292.
239. ↑ "Effects of Pharmacotherapy on Combat-Related PTSD, Anxiety, and Depression: A Systematic Review and Meta-Regression Analysis". PLOS ONE 10 (5). 28 May 2015. doi:10.1371/journal.pone.0126529. PMID 26020791. Bibcode: 2015PLoSO..1026529P. "The cumulative evidence summarized in this review indicates that pharmacotherapy significantly reduces PTSD, anxiety, and depressive symptom severity among combat veterans with PTSD. The magnitude of the overall effects of pharmacotherapy on PTSD (Δ = 0.38), anxiety (Δ = 0.42), and depressive symptoms (Δ = 0.52) were moderate...".
240. ↑ "Patient-reported outcomes in post-traumatic stress disorder. Part II: focus on pharmacological treatment" (in en, es, fr). Dialogues in Clinical Neuroscience 16 (2): 227–237. June 2014. doi:10.31887/DCNS.2014.16.2/hkapfhammer. PMID 25152660.
241. ↑ "Concordance between psychotropic prescribing for veterans with PTSD and clinical practice guidelines". Psychiatric Services 63 (2): 154–60. February 2012. doi:10.1176/appi.ps.201100199. PMID 22302333.
242. ↑ "[Posttraumatic stress disorder (PTSD) as a consequence of the interaction between an individual genetic susceptibility, a traumatogenic event and a social context]" (in fr). L'Encéphale 38 (5): 373–80. October 2012. doi:10.1016/j.encep.2011.12.003. PMID 23062450.
243. ↑ "[Therapeutic possibilities after traumatic experiences]". Psychiatria Danubina 20 (4): 532–45. December 2008. PMID 19011595.
244. ↑ Post-traumatic Stress Disorder. Epocrates.com. 2005.
245. ↑ Psychotropic drugs: fast facts (3rd ed.). New York: W.W. Norton & Company. 2002. p. 349. ISBN 978-0-393-70301-6.
246. ↑ "[Three paradigms in the treatment of posttraumatic stress disorder]". Neuropsychopharmacologia Hungarica 7 (1): 11–21. March 2005. PMID 16167463.
247. ↑ 247.0 247.1 Veterans Affairs and Department of Defense clinical practice guideline for management of post-traumatic stress.. VA/DoD. 2010.
248. ↑ "World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders – first revision". The World Journal of Biological Psychiatry 9 (4): 248–312. 2008. doi:10.1080/15622970802465807. PMID 18949648.
249. ↑ Gilbert, Michael; Dinh La, Andrew; Romulo Delapaz, Noah; Kenneth Hor, William; Fan, Peihao; Qi, Xiguang; Guo, Xiaojiang; Ying, Jian et al. (2020-10-29). "An Emulation of Randomized Trials of Administrating Benzodiazepines in PTSD Patients for Outcomes of Suicide-Related Events". Journal of Clinical Medicine 9 (11): 3492. doi:10.3390/jcm9113492. ISSN 2077-0383. PMID 33138006.
250. ↑ "Prazosin in the treatment of PTSD". Journal of Psychiatric Practice 20 (4): 253–9. July 2014. doi:10.1097/01.pra.0000452561.98286.1e. PMID 25036580.
251. ↑ "Efficacy of Prazosin in Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis". The Primary Care Companion for CNS Disorders 18 (4). July 2016. doi:10.4088/PCC.16r01943. PMID 27828694.
252. ↑ "Post-traumatic stress disorder: revisiting adrenergics, glucocorticoids, immune system effects and homeostasis". Clinical & Translational Immunology 3 (11). November 2014. doi:10.1038/cti.2014.26. PMID 25505957.
253. ↑ "Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis". The Lancet. Psychiatry 6 (12): 995–1010. December 2019. doi:10.1016/S2215-0366(19)30401-8. PMID 31672337.
254. ↑ "Benefits and Harms of Plant-Based Cannabis for Posttraumatic Stress Disorder: A Systematic Review". Annals of Internal Medicine 167 (5): 332–340. September 2017. doi:10.7326/M17-0477. PMID 28806794.
255. ↑ Kansagara, Devan; Terry, Garth E.; Ayers, Chelsea K.; D'Souza, Deepak C. (2026-03-09). "Cannabis and Mental Health: A Review" (in en). JAMA Internal Medicine. doi:10.1001/jamainternmed.2025.8215. ISSN 2168-6106.
256. ↑ "Use and effects of cannabinoids in military veterans with posttraumatic stress disorder". American Journal of Health-System Pharmacy 72 (15): 1279–84. August 2015. doi:10.2146/ajhp140523. PMID 26195653.
257. ↑ "Long-term Nabilone Use: A Review of the Clinical Effectiveness and Safety". CADTH Rapid Response Reports. October 2015. PMID 26561692. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0079568/.
258. ↑ "Raimondo signs law allowing marijuana for treatment of PTSD". The Providence Journal. 2016-07-13. http://www.providencejournal.com/news/20160713/raimondo-signs-law-allowing-marijuana-for-treatment-of-ptsd.
259. ↑ "Sports and games for post-traumatic stress disorder (PTSD)". The Cochrane Database of Systematic Reviews 2010 (1). January 2010. doi:10.1002/14651858.CD007171.pub2. PMID 20091620. PMC 7390394. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014346/.
260. ↑ "PTSD and physical health". Information on trauma and PTSD for professionals, National Center for PTSD. U.S. Department of Veterans Affairs. http://www.ptsd.va.gov/professional/pages/ptsd-physical-health.asp.
261. ↑ U.S. Department of Veterans Affairs. "Lifestyle Changes Recommended for PTSD Patients". Information on trauma and PTSD for veterans, general public and family from the National Center for PTSD. U.S. Department of Veterans Affairs. http://www.ptsd.va.gov/public/pages/coping-ptsd-lifestyle-changes.asp.
262. ↑ 262.0 262.1 "The effectiveness of interventions to reduce psychological harm from traumatic events among children and adolescents: a systematic review". American Journal of Preventive Medicine 35 (3): 287–313. September 2008. doi:10.1016/j.amepre.2008.06.024. PMID 18692745. https://www.ncbi.nlm.nih.gov/books/NBK75361/.
263. ↑ "7". Child psychopathology (2nd ed.). New York: Guilford Press. 2003. pp. 330–371. ISBN 978-1-57230-609-7. https://archive.org/details/childpsychopatho00mash_735.
264. ↑ "Marine Corps Offers Yoga, Massages to Marriages Strained by War". Fox News. Associated Press. 2008-04-02. https://www.foxnews.com/story/marine-corps-offers-yoga-massages-to-marriages-strained-by-war.
265. ↑ "Private Hospital Network to Help VA with Mental Health Care for Vets". Military.com. November 6, 2015. http://www.military.com/daily-news/2015/11/06/private-hospital-network-to-help-va-mental-health-care-vets.html.
266. ↑ "Covering all the bases for veterans". The Boston Globe. May 2, 2016. https://www.bostonglobe.com/metro/massachusetts/2016/05/02/changing-culture/CAjKLHyN6c5xobx8sdgKCO/story.html.
267. ↑ "FDA approves Apple Watch app NightWare to treat PTSD nightmares". 11 November 2020. https://kyma.com/videor/2020/11/11/fda-approves-apple-watch-app-nightware-to-treat-ptsd-nightmares/.
268. ↑ 268.0 268.1 268.2 "Mortality and Burden of Disease Estimates for WHO Member States: Persons, all ages (2004)" (xls). World Health Organization. 2004. https://www.who.int/entity/healthinfo/global_burden_disease/gbddeathdalycountryestimates2004.xls.
269. ↑ "Don't throw out the baby with the bathwater (PTSD is not overdiagnosed)". Canadian Journal of Psychiatry 52 (8): 501–2; discussion 503. August 2007. doi:10.1177/070674370705200805. PMID 17955912.
270. ↑ "National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria". Journal of Traumatic Stress 26 (5): 537–47. October 2013. doi:10.1002/jts.21848. PMID 24151000.
271. ↑ 271.0 271.1 "Mortality and Burden of Disease Estimates for WHO Member States: Females, all ages (2004)" (xls). World Health Organization. 2004. https://www.who.int/entity/healthinfo/global_burden_disease/gbddeathdalycountryestimates_female_2004.xls.
272. ↑ 272.0 272.1 "Mortality and Burden of Disease Estimates for WHO Member States: Males, all ages (2004)" (xls). World Health Organization. 2004. https://www.who.int/entity/healthinfo/global_burden_disease/gbddeathdalycountryestimates_male_2004.xls.
273. ↑ 273.0 273.1 "Posttraumatic stress disorder in the World Mental Health Surveys". Psychological Medicine 47 (13): 2260–2274. October 2017. doi:10.1017/S0033291717000708. PMID 28385165.
274. ↑ Nuwer, Rachel (Sep 14, 2023). "MDMA Therapy for PTSD Inches Closer to U.S. Approval". The New York Times. New York Times. https://www.nytimes.com/2023/09/14/health/mdma-ptsd-psychedelics.html.
275. ↑ "Neurobiology of suicidal behavior in post-traumatic stress disorder". Expert Review of Neurotherapeutics 10 (8): 1233–5. August 2010. doi:10.1586/ern.10.114. PMID 20662745.
276. ↑ "The War's Costs". 2007. http://www.digitalhistory.uh.edu/database/article_display.cfm?HHID=513.
277. ↑ "Findings from the National Vietnam Veterans' Readjustment Study – Factsheet". United States Department of Veterans Affairs. National Center for PTSD. http://ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_nvvrs.html?printable-template=factsheet.
278. ↑ 278.0 278.1 "Psychological Costs of War: Military Combat and Mental Health". Journalistsresource.org. 2012-02-27. http://journalistsresource.org/studies/government/federalstate/psychological-costs-war-military-combat-mental-health/.
279. ↑ Screening for Post-Traumatic Stress Disorder (PTSD) in Primary Care: A Systematic Review. VA Evidence-based Synthesis Program Reports. Department of Veterans Affairs. January 2013. https://www.ncbi.nlm.nih.gov/books/NBK126691/.
280. ↑ "Mission Critical: Getting Vets With PTSD Back to Work". NIOSH: Workplace Safety and Health (Medscape & NIOSH). March 29, 2013. http://www.medscape.com/viewarticle/781380_2.
281. ↑ 281.0 281.1 281.2 281.3 281.4 281.5 "9/11-related PTSD among highly exposed populations: a systematic review 15 years after the attack". Psychological Medicine 48 (4): 537–553. March 2018. doi:10.1017/S0033291717002033. PMID 28805168.
282. ↑ 282.0 282.1 282.2 282.3 "Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers". The American Journal of Psychiatry 164 (9): 1385–94. September 2007. doi:10.1176/appi.ajp.2007.06101645. PMID 17728424.
283. ↑ 283.0 283.1 283.2 283.3 283.4 "Enduring mental health morbidity and social function impairment in world trade center rescue, recovery, and cleanup workers: the psychological dimension of an environmental health disaster". Environmental Health Perspectives 116 (9): 1248–53. September 2008. doi:10.1289/ehp.11164. PMID 18795171. Bibcode: 2008EnvHP.116.1248S.
284. ↑ 284.0 284.1 284.2 284.3 284.4 "Anthropological discourses on the globalization of posttraumatic stress disorder (PTSD) in post-conflict societies". Journal of Psychiatric Practice 18 (1): 29–37. 2012. doi:10.1097/01.pra.0000410985.53970.3b. PMID 22261981.
285. ↑ "Language, Translation, Trauma". Annual Review of Anthropology 45: 95–111. 2016. doi:10.1146/annurev-anthro-102215-100232.
286. ↑ 286.0 286.1 "Nepali concepts of psychological trauma: the role of idioms of distress, ethnopsychology and ethnophysiology in alleviating suffering and preventing stigma". Culture, Medicine and Psychiatry 34 (2): 322–352. 2010. doi:10.1007/s11013-010-9170-2. PMID 20309724.
287. ↑ "The sequelae of political violence: assessing trauma, suffering and dislocation in the Peruvian highlands". Social Science & Medicine 67 (2): 205–217. July 2008. doi:10.1016/j.socscimed.2008.03.040. PMID 18423959.
288. ↑ Psychological Rehabilitation of Ex-combatants in Non-Western, Post-conflict Settings, Trauma Rehabilitation After War and Conflict. New York, NY: Springer. 2010. doi:10.1007/978-1-4419-5722-1_9.
289. ↑ "From shell shock and war neurosis to posttraumatic stress disorder: a history of psychotraumatology". Dialogues in Clinical Neuroscience 2 (1): 47–55. March 2000. doi:10.31887/DCNS.2000.2.1/macrocq. PMID 22033462.
290. ↑ "The DSM-5: Classification and criteria changes". World Psychiatry 12 (2): 92–98. June 2013. doi:10.1002/wps.20050. PMID 23737408.
291. ↑ "Cross-cultural perspectives on posttraumatic stress". Clinician's Guide to Posttraumatic Stress Disorder. 2010. pp. 235–261. doi:10.1002/9781118269961.ch10. ISBN 978-0-470-45095-6.
292. ↑ "VA Compensation Rate Table". Department of Veterans Affairs. http://www.vba.va.gov/bln/21/Rates/comp01.htm.
293. ↑ "Access VA Health Benefits". Department of Veterans Affairs. http://www.va.gov/healthbenefits/access/.
294. ↑ "VA Vocational Rehabilitation". Department of Veterans Affairs. http://www.vba.va.gov/bln/vre/.
295. ↑ "Vet Success". Department of Veterans Affairs + State Government Veterans Agencies. http://vetsuccess.gov.
296. ↑ "Independent Living Support for Veterans". Department of Veterans Affairs. http://www.vba.va.gov/bln/vre/ilp.htm.
297. ↑ "Veterans Benefits". Veterans Benefits Administration. http://www.vba.va.gov/VBA/.
298. ↑ "Lance Corporal Johnson Beharry accuses Government of neglecting soldiers". The Times (London). February 28, 2009. https://www.thetimes.com/article/lance-corporal-johnson-beharry-accuses-government-of-neglecting-soldiers-f0h9rdp29qk.
299. ↑ "UK | Full interview: L/Cpl Johnson Beharry". BBC News. 2009-02-28. https://news.bbc.co.uk/2/hi/uk_news/7916852.stm.
300. ↑ "The Operational Stress Injury Social Support (OSISS) Program for Canadian Veterans". http://www.osiss.ca/engraph/index_e.asp. See also "Evaluation of the OSISS Peer Support Network". Dept. of National Defence and Veterans Affairs Canada. January 2005. http://www.veterans.gc.ca/pdf/deptReports/OSISS-Eval-Final-Rpt-Jan05(Nov04-05)-eng.pdf.
301. ↑ "Operational Stress Injury Social Support: a Canadian innovation in professional peer support". Canadian Military Journal 9 (1): 57–64. 2008. http://www.journal.forces.gc.ca/vo9/no1/09-richardson-eng.asp. Retrieved 2014-01-30.
302. ↑ "The New Veterans Charter for CF Veterans and their Families". Vac-Acc.Gc.Ca. 2006-07-12. http://www.vac-acc.gc.ca/clients/sub.cfm?source=Forces/nvc&CFID=9295860&CFTOKEN=39698927.
303. ↑ Magazine, Smithsonian; Clark, Laura. "Ancient Assyrian Soldiers Were Haunted by War, Too". https://www.smithsonianmag.com/smart-news/ancient-assyrian-soldiers-were-haunted-war-too-180954022/.
304. ↑ "Killing rage: physis or nomos—or both". War and Violence in Ancient Greece. Duckworth and the Classical Press of Wales. 2000. pp. 31–56. ISBN 0-7156-3046-6.
305. ↑ "Henry IV, Part I, Act II, Scene 3". Open Source Shakespeare. http://www.opensourceshakespeare.org/views/plays/play_view.php?WorkID=henry4p1&Act=2&Scene=3&Scope=scene.
306. ↑ Achilles in Vietnam: Combat Trauma and the Undoing of Character. Scribner. 1994. pp. 165–66.
307. ↑ Brave New Brain: Conquering Mental Illness in the Era of the Genome. New York: Oxford University Press. Feb 19, 2004. p. 303. ISBN 978-0-19-516728-3.
308. ↑ "From Nostalgia to Post-Traumatic Stress Disorder: A Mass Society Theory of Psychological Reactions to Combat.". Inquiries Journal 5 (2): 1–3. 2013. http://www.studentpulse.com/articles/727/from-nostalgia-to-post-traumatic-stress-disorder-a-mass-society-theory-of-psychological-reactions-to-combat.
309. ↑ "World War One – A New Kind of War, Part II". www.ralphmag.org. http://www.ralphmag.org/CG/world-war-one2.html. , From 14 – 18 Understanding the Great War, by Stéphane Audoin-Rouzeau, Annette Becker[incomplete short citation]
310. ↑ 310.0 310.1 "Posttraumatic stress disorder: a history and a critique". Annals of the New York Academy of Sciences 1208 (Psychiatric and Neurologic Aspects of War): 67–71. October 2010. doi:10.1111/j.1749-6632.2010.05699.x. PMID 20955327. Bibcode: 2010NYASA1208...67A.
311. ↑ 311.0 311.1 American Psychiatric Association (1952). Diagnostic and Statistical Manual. American Psychiatric Association Mental Hospital Service. p. 40. OCLC 7919761.
312. ↑ "When trauma tips you over: PTSD Part 1". Australian Broadcasting Commission. 9 October 2004. http://www.abc.net.au/rn/allinthemind/stories/2004/1214098.htm.
313. ↑ The Victim of Rape: Institutional Reactions. Wiley-Interscience. 1978. ISBN 978-0-471-40785-0. https://archive.org/details/victimo_hol_1978_00_0399.
314. ↑ 314.0 314.1 International handbook of human response to trauma. New York: Kluwer Academic/Plenum Press. 2000. ISBN 978-0-306-46095-1. http://www.istss.org/what/history2.cfm.
315. ↑ "Emotional Effects on USAF Personnel of Recovering and Identifying Victims from Jonestown, Guyana". 1982-04-01. https://apps.dtic.mil/dtic/tr/fulltext/u2/a115592.pdf.
316. ↑ "PTSD, the Traumatic Principle and Lawsuits". Psychiatric Times. 2 August 1999. http://www.psychiatrictimes.com/ptsd-traumatic-principle-and-lawsuits.
317. ↑ "International Statistical Classification of Diseases and Related Health Problems 10th Revision Version for 2007". World Health Organization. 2007. http://apps.who.int/classifications/apps/icd/icd10online2007/index.htm?gf40.htm+F431.
318. ↑ "Civilian PTSD Symptoms and Risk for Involvement in the Criminal Justice System". Journal of the Academy of Psychiatry and the Law 40 (4): 522–529. 2012-12-01. ISSN 1093-6793. http://www.jaapl.org/content/40/4/522.full?sid=b7a23ae3-d147-48af-b8fc-310fa08605e7. Retrieved 2014-11-29.
319. ↑ DSM-5. http://repository.poltekkes-kaltim.ac.id/657/1/Diagnostic and statistical manual of mental disorders _ DSM-5 ( PDFDrive.com ).pdf. Retrieved 10 January 2022.
320. ↑ "Search results: 'post-traumatic stress disorder' in the title of a journal article". U.S. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/?term=post-traumatic stress disorder[Title].
321. ↑ "PTSD". Farlex, Inc.. http://www.thefreedictionary.com/PTSD.
322. ↑ "Prevalence of post-traumatic stress disorder symptoms in adult critical care survivors: a systematic review and meta-analysis". Critical Care 23 (1). June 2019. doi:10.1186/s13054-019-2489-3. PMID 31186070.
323. ↑ "The Disappearing 'Disorder': Why PTSD is becoming PTS". Time. 2011. https://nation.time.com/2011/06/05/the-disappearing-disorder-why-ptsd-is-becoming-pts/.
324. ↑ "George Carlin: Euphemism Fighter Supreme". 19 May 2017. https://www.mcsweeneys.net/articles/george-carlin-euphemism-fighter-supreme.
325. ↑ "TRC Special Report 78, Part 5". 14 December 1997. https://sabctrc.saha.org.za/tvseries/episode78.
326. ↑ "Is traumatic stress research global? A bibliometric analysis". European Journal of Psychotraumatology 5 (1). 2014. doi:10.3402/ejpt.v5.23269. PMID 24563730.
327. ↑ 327.0 327.1 "Neurobehavioral, neuropathological and biochemical profiles in a novel mouse model of co-morbid post-traumatic stress disorder and mild traumatic brain injury". Frontiers in Behavioral Neuroscience 8: 213. December 2014. doi:10.3389/fnbeh.2014.00213. PMID 25002839.
328. ↑ "Amnesia for early life stress does not preclude the adult development of posttraumatic stress disorder symptoms in rats". Biological Psychiatry 76 (4): 306–14. August 2014. doi:10.1016/j.biopsych.2013.10.007. PMID 24231200.
329. ↑ "Stellate Ganglion Blocks". StatPearls (StatPearls Publishing LLC). 2020. PMID 29939575. https://www.ncbi.nlm.nih.gov/books/NBK507798/.
330. ↑ 330.0 330.1 "Examining military population and trauma type as moderators of treatment outcome for first-line psychotherapies for PTSD: A meta-analysis". Journal of Anxiety Disorders 67. October 2019. doi:10.1016/j.janxdis.2019.102133. PMID 31472332.
331. ↑ "A guide to guidelines for the treatment of posttraumatic stress disorder in adults: An update". Psychotherapy 56 (3): 359–373. September 2019. doi:10.1037/pst0000231. PMID 31282712. http://orca.cf.ac.uk/131829/1/CPG Review of Guidelines 111218. CC edit 03_02_19 revision clean.pdf.
332. ↑ "Long-term efficacy of psychotherapy for posttraumatic stress disorder: A meta-analysis of randomized controlled trials". Clinical Psychology Review 59: 30–40. February 2018. doi:10.1016/j.cpr.2017.10.009. PMID 29169664.
333. ↑ "A Systematic Review of Dropout From Psychotherapy for Posttraumatic Stress Disorder Among Iraq and Afghanistan Combat Veterans". Journal of Traumatic Stress 28 (5): 401–9. October 2015. doi:10.1002/jts.22038. PMID 26375387.
334. ↑ "Comparative Efficacy and Acceptability of Pharmacological, Psychotherapeutic, and Combination Treatments in Adults With Posttraumatic Stress Disorder: A Network Meta-analysis". JAMA Psychiatry 76 (9): 904–913. June 2019. doi:10.1001/jamapsychiatry.2019.0951. PMID 31188399.
335. ↑ Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder: A Systematic Review Update. AHRQ Comparative Effectiveness Reviews. Rockville, MD: Agency for Healthcare Research and Quality (US). 2018. https://www.ncbi.nlm.nih.gov/books/NBK525132/.
336. ↑ "Efficacy of interpersonal psychotherapy for post-traumatic stress disorder: A systematic review and meta-analysis". Journal of Affective Disorders 264: 286–294. March 2020. doi:10.1016/j.jad.2019.12.021. PMID 32056763.

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## External links

* Post traumatic stress disorder information from The National Child Traumatic Stress Network
* Information resources from The University of Queensland School of Medicine
* APA practice parameters for assessment and treatment for PTSD (Updated 2025)
* Resources for professionals from the VA National PTSD Center

Classification|

* ICD-11: 6B40
* ICD-10: F43.1
* ICD-9-CM: 309.81
* MeSH: D013313
* DiseasesDB: 33846

|

External resources|

* MedlinePlus: 000925
* eMedicine: med/1900

* v
* t
* e

Mental and behavioral disorders (F00–F99 & 290–319)

Adult personality and behavior

| Gender dysphoria|

* Ego-dystonic sexual orientation
* Paraphilia
* Fetishism
* Voyeurism
* Sexual maturation disorder
* Sexual relationship disorder

|

Other|

* Factitious disorder
* Munchausen syndrome
* Impulse control disorder
* Dermatillomania
* Kleptomania
* Pyromania
* Trichotillomania
* Personality disorder

Childhood and learning

| Emotional and behavioral|

* ADHD
* Conduct disorder
* ODD
* Emotional and behavioral disorders
* Separation anxiety disorder
* Movement disorders
* Stereotypic
* Social functioning
* DAD
* RAD
* Selective mutism
* Speech
* Stuttering
* Cluttering
* Tic disorder
* Tourette syndrome

|

Intellectual disability|

* X-linked intellectual disability
* Lujan–Fryns syndrome

Psychological development
(developmental disabilities)|

* Pervasive
* Specific

Mood (affective)

* Bipolar
* Bipolar I
* Bipolar II
* Bipolar NOS
* Cyclothymia
* Depression
* Atypical depression
* Dysthymia
* Major depressive disorder
* Melancholic depression
* Seasonal affective disorder
* Mania

Neurological and symptomatic

| Autism spectrum|

* Autism
* Asperger syndrome
* High-functioning autism
* PDD-NOS
* Savant syndrome

|

Dementia|

* AIDS dementia complex
* Alzheimer's disease
* Creutzfeldt–Jakob disease
* Frontotemporal dementia
* Huntington's disease
* Mild cognitive impairment
* Parkinson's disease
* Pick's disease
* Sundowning
* Vascular dementia
* Wandering

Other|

* Delirium
* Organic brain syndrome
* Post-concussion syndrome

Neurotic, stress-related and somatoform

| Adjustment|

* Adjustment disorder with depressed mood

|

Anxiety|

| Phobia|

* Agoraphobia
* Social anxiety
* Social phobia
* Anthropophobia
* Specific social phobia
* Specific phobia
* Claustrophobia

|

Other|

* Generalized anxiety disorder
* OCD
* Panic attack
* Panic disorder
* Stress
* Acute stress reaction
* PTSD

Dissociative|

* Depersonalization disorder
* Dissociative identity disorder
* Fugue state
* Psychogenic amnesia

Somatic symptom|

* Body dysmorphic disorder
* Conversion disorder
* Ganser syndrome
* Globus pharyngis
* Da Costa's syndrome
* Hypochondriasis
* Mass psychogenic illness
* Neurasthenia
* Nosophobia
* Psychalgia
* Somatization disorder

Physiological and physical behavior

| Eating|

* Anorexia nervosa
* Bulimia nervosa
* Rumination syndrome
* Other specified feeding or eating disorder

|

Nonorganic
sleep|

* Hypersomnia
* Insomnia
* Parasomnia
* Night terror
* Nightmare
* REM sleep behavior disorder

Postnatal|

* Postpartum depression
* Postpartum psychosis

Sexual dysfunction|

| Arousal|

* Erectile dysfunction
* Female sexual arousal disorder

|

Desire|

* Hypersexuality
* Hypoactive sexual desire disorder

Orgasm|

* Anorgasmia
* Delayed ejaculation
* Premature ejaculation
* Sexual anhedonia

Pain|

* Nonorganic dyspareunia
* Nonorganic vaginismus

Psychoactive substances, substance abuse and substance-related

* Drug overdose
* Intoxication
* Physical dependence
* Rebound effect
* Stimulant psychosis
* Substance dependence
* Withdrawal

Schizophrenia, schizotypal and delusional

| Delusional|

* Delusional disorder
* Folie à deux

|

Psychosis and
schizophrenia-like|

* Brief reactive psychosis
* Schizoaffective disorder
* Schizophreniform disorder

Schizophrenia|

* Childhood schizophrenia
* Disorganized (hebephrenic) schizophrenia
* Paranoid schizophrenia
* Pseudoneurotic schizophrenia
* Simple-type schizophrenia

Symptoms and uncategorized

* Catatonia
* False pregnancy
* Intermittent explosive disorder
* Klüver–Bucy syndrome
* Psychogenic non-epileptic seizures
* Psychomotor agitation
* Stereotypy

* v
* t
* e

Trauma

Principles|

* Polytrauma
* Major trauma
* Traumatology
* Triage
* Resuscitation
* Trauma triad of death

Assessment|

| Clinical prediction rules|

* Revised Trauma Score
* Injury Severity Score
* Abbreviated Injury Scale
* NACA score

|

Investigations|

* Diagnostic peritoneal lavage
* Focused assessment with sonography for trauma

Management|

| Principles|

* Advanced trauma life support
* Trauma surgery
* Trauma center
* Trauma team
* Damage control surgery
* Early appropriate care

|

Procedures|

* Resuscitative thoracotomy

Pathophysiology|

| Injury|

* MSK
* Bone fracture
* Joint dislocation
* Degloving
* Soft tissue injury
* Resp
* Flail chest
* Pneumothorax
* Hemothorax
* Diaphragmatic rupture
* Pulmonary contusion
* Cardio
* Internal bleeding
* Thoracic aorta injury
* Cardiac tamponade
* GI
* Blunt kidney trauma
* Ruptured spleen
* Neuro
* Penetrating head injury
* Traumatic brain injury
* Intracranial hemorrhage

|

Mechanism|

* Blast injury
* Blunt trauma
* Burn
* Penetrating trauma
* Crush injury
* Stab wound
* Ballistic trauma
* Electrocution

Region|

* Abdominal trauma
* Chest trauma
* Facial trauma
* Head injury
* Spinal cord injury

Demographic|

* Geriatric trauma
* Pediatric trauma

Complications|

* Posttraumatic stress disorder
* Wound healing
* Acute lung injury
* Crush syndrome
* Rhabdomyolysis
* Compartment syndrome
* Contracture
* Volkmann's contracture
* Fat embolism
* Chronic traumatic encephalopathy

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