How common is PTSD?

Post-traumatic stress disorder (PTSD) can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or that you have no control over what is happening.

Experiencing a traumatic event is not rare. About 60% of men and 50% of women experience this type of event in their lives. Women are more likely to experience sexual assault and child sexual abuse. Men are more likely to experience accidents, physical assault, combat, or disaster or to witness death or injury.

But going through a traumatic event doesn't mean you'll get PTSD. About 8% of men and 20% of women develop PTSD after a traumatic event.

Here are some facts:

• In the United States, about 8% of the population will have PTSD symptoms at some point in their lives.
• About 5.2 million adults have PTSD during a given year. This is only a small portion of those who have experienced a traumatic event.
• Women are more likely than men to develop PTSD. About 10% of women develop PTSD compared with 5% of men
• Women are more likely than men to develop PTSD for all types of traumatic events, except sexual assault or abuse. When these traumas occur, men are just as likely as women to get PTSD

Who is most likely to develop PTSD?

Most people who experience a traumatic event will not develop PTSD. However, you are more likely to develop PTSD if you:

• Were directly exposed to the traumatic event as a victim or a witness
• Were seriously injured during the event
• Went through a trauma that was long lasting or very severe
• Believed that you were in danger
• Believed that a family member was in danger
• Had a severe reaction during the event, such as crying, shaking, vomiting, or feeling apart from your surroundings
• Felt helpless during the trauma and were not able to help yourself or a loved one.

You are also more likely to develop PTSD if you:

• Had an earlier life-threatening event or trauma, such as being abused as a child
• Have another mental health problem
• Have family members who have had mental health problems
• Have little support from family and friends
• Have recently lost a loved one, especially if it was unexpected
• Have had recent, stressful life changes
• Drink a lot of alcohol
• Are a woman
• Are poorly educated
• Are younger

Some groups of people, including blacks and Hispanics, may be more likely than whites to develop PTSD. This may be because these groups are more likely to experience a traumatic event. For example, in Vietnam, whites were in less combat than blacks, Hispanics, or Native Americans.

Your culture or ethnic group also may affect how you react to PTSD. For example, people from groups that are open and willing to talk about problems may be more willing to seek help.

PTSD and the Military

If you are in the military, you may have seen combat. You may have been on missions that exposed you to horrible and life-threatening experiences. You may have been shot at, seen a buddy shot, or seen death. These are types of events that can lead to PTSD.

Experts think PTSD occurs:

• In about 30% of Vietnam veterans, or about 30 out of 100 Vietnam veterans.
• In as many as 10% of Gulf War (Desert Storm) veterans, or in 10 veterans out of 100.9
• In about 6% to 11% of veterans of the Afghanistan war (Enduring Freedom), or in 6 to 11 veterans out of 100.
• In about 12% to 20% of veterans of the Iraq war (Iraqi Freedom), or in 12 to 20 veterans out of 100.

Other factors in a combat situation can add more stress to an already stressful situation and may contribute to PTSD and other mental health problems. These factors include what you do in the war, the politics around the war, where it's fought, and the type of enemy you face.

Another cause of PTSD in the military can be military sexual trauma (MST). This is any sexual harassment or sexual assault that occurs while you are in the military. MST can happen to men and women and can occur during peacetime, training, or war.

Among veterans using VA health care, about:

• 23 out of 100 women (23%) reported sexual assault when in the military
• 55 out of 100 women (55%) and 38 out of 100 men (38%) have experienced sexual harassment when in the military

Even though military sexual trauma is far more common in women, over half of all veterans with military sexual trauma are men.

How Common is Post-Traumatic Stress Disorder?

Twenty-five hundred St. Louis residents were interviewed. Fifteen percent of both sexes had had some of the symptoms of post-traumatic stress, especially nightmares and jumpiness, but fewer than one percent had ever had the full syndrome of PTSD. Certain symptoms, such as emotional numbing, were very rare. Women had PTSD at more than twice the rate of men. In women, the most common cause was a physical assault; in men, all cases resulted from combat or from seeing someone get hurt or die. In about half of the cases, the symptoms lasted less than 6 months; in about a third, they lasted longer than 3 years.

The interview subjects included 43 Vietnam combat soldiers, 15 of whom had been wounded. Three (20 percent) of the wounded men, but only one of the other 28 combat soldiers, had ever suffered from PTSD. Of the 69 people who had been beaten or mugged in the 18 months before the interview, 2 had suffered from PTSD and 13 had some of its symptoms.

Eighty percent of people with PTSD had other psychiatric disorders as well; the most common were obsessive-compulsive disorder and mood disorders. Victims of PTSD also had a high rate of truancy, vandalism, alcohol use, and running away before the age of 15 -- common precursors of substance dependence and antisocial personality. People with these childhood problems were also more likely to be in combat or physically attacked later in life, but that alone did not explain their susceptibility to PTSD, because the disorder was less common in other combat soldiers and assault victims.

John E. Helzer, Lee N. Robins, and Larry McEvoy. Post-traumatic stress disorder in the general population: findings of the epidemiologic catchment area survey. New England Journal of Medicine, 317:1630-1634 (December 24, 1987).

Internet Mental Health (www.mentalhealth.com) copyright © 1995-1997 by Phillip W. Long, M.D.