PTSD,risk Factors

Risk factors

<div class="rellink boilerplate seealso">See also: <a title="Psychological resilience" href="/wiki/Psychological_resilience">Psychological resilience</a></div>

Although most people (50–90%) encounter trauma over a lifetime,<a href="#cite_note-Kessler95-63">[62]</a><a href="#cite_note-64">[63]</a> about 20-30% develop PTSD but over half of these people will recover without treatment.<a href="#cite_note-Rothschild_2000-5">[4]</a><a href="#cite_note-Kessler95-63">[62]</a> Vulnerability to PTSD presumably stems from an interaction of biological diathesis, early childhood developmental experiences, and trauma severity.<a href="#cite_note-Rothschild_2000-5">[4]</a> A person that never established secure relationships and learned coping skills as a young child if exposed to a traumatic experience is more likely to develop PTSD than one that developed good coping skills and has a support network.<a href="#cite_note-Rothschild_2000-5">[4]</a>

Predictor models have consistently found that childhood trauma, chronic adversity, and familial stressors increase risk for PTSD as well as risk for biological markers of risk for PTSD after a traumatic event in adulthood.<a href="#cite_note-65">[64]</a><a href="#cite_note-66">[65]</a><a href="#cite_note-67">[66]</a><a href="#cite_note-68">[67]</a> Peritraumatic dissociation in children is a predictive indicator of the development of PTSD later in life.<a href="#cite_note-Skelton_2012_628.E2.80.93637-39">[38]</a> This effect of childhood trauma, which is not well understood, may be a marker for both traumatic experiences and attachment problems.<a href="#cite_note-69">[68]</a><a href="#cite_note-70">[69]</a> Proximity to, duration of, and severity of the trauma also make an impact, and interpersonal traumas cause more problems than impersonal ones.<a href="#cite_note-71">[70]</a>

<h4>Military experience</h4>

Schnurr, Lunney, and Sengupta<a href="#cite_note-jtraumastress-60">[59]</a> identified risk factors for the development of PTSD in <a title="Vietnam veteran" href="/wiki/Vietnam_veteran">Vietnam veterans</a>. Among those are:

<ul>

<li><a class="mw-redirect" title="Hispanics" href="/wiki/Hispanics">Hispanic ethnicity</a>, coming from an unstable family, being punished severely during childhood, childhood asocial behavior, and depression as pre-military factors</li>

<li>War-zone exposure, <a title="Dissociation (psychology)" href="/wiki/Dissociation_(psychology)">peritraumatic dissociation</a>, depression as military factors</li>

<li>Recent stressful life events, post-<a title="Vietnam War" href="/wiki/Vietnam_War">Vietnam</a> trauma, and depression as post-military factors</li>

</ul>

They also identified certain protective factors, such as:

<ul>

<li><a class="mw-redirect" title="Japanese-American" href="/wiki/Japanese-American">Japanese-American</a> ethnicity, high school degree or college education, older age at entry to war, higher socioeconomic status, and a more positive paternal relationship as pre-military protective factors</li>

<li>Social support at homecoming and current social support as post-military factors.<a href="#cite_note-autogenerated2-72">[71]</a> Other research also indicates the protective effects of social support in averting PTSD or facilitating recovery if it develops.<a href="#cite_note-Brewin-73">[72]</a><a href="#cite_note-Ozer-74">[73]</a></li>

</ul>

Glass and Jones found early intervention to be a critical preventive measure:

"PTSD symptoms can follow any serious psychological trauma, such as exposure to combat, accidents, torture, disasters, criminal assault and exposure to atrocities or to the sequelae of such extraordinary events. Prisoners of war exposed to harsh treatment are particularly prone to develop PTSD. In their acute presentation these symptoms, which include subsets of a large variety of affective, cognitive, perceptional, emotional and behavioral responses which are relatively normal responses to gross psychological trauma. If persistent, however, they develop a life of their own and may be maintained by inadvertent reinforcement. Early intervention and later avoidance of positive reinforcement (which may be subtle) for such symptoms is a critical preventive measure.<a href="#cite_note-75">[74]</a>

</blockquote>

Studies have shown that those prepared for the potential of a traumatic experience are more prepared to deal with the stress of a traumatic experience and therefore less likely to develop PTSD.<a href="#cite_note-Rothschild_2000-5">[4]</a>

<h4>[<a title="Edit section: Foster care" href="/w/index.php?title=Posttraumatic_stress_disorder&action=edit&section=11">edit</a>] Foster care</h4>

In the Casey Family Northwest Alumni Study, conducted in conjunction with researchers from the <a title="Harvard Medical School" href="/wiki/Harvard_Medical_School">Harvard Medical School</a> in Oregon and Washington state, the rate of PTSD in adults who were in <a title="Foster care" href="/wiki/Foster_care">foster care</a> for one year between the ages of 14–18 was found to be higher than that of combat veterans. Up to 25% of those in the study meet the diagnostic criteria for PTSD as compared to 12–13% of Iraq war veterans and 15% of Vietnam War veterans, and a rate of 4% in the general population. The recovery rate for foster home alumni was 28.2% as opposed to 47% in the general population.<a href="#cite_note-76">[75]</a><a href="#cite_note-77">[76]</a>

Dubner and Motta (1999)<a href="#cite_note-78">[77]</a> found that 60% of children in foster care who had experienced sexual abuse had PTSD, and 42% of those who had been physically abused met the PTSD criteria. PTSD was also found in 18% of the children who were not abused. These children may have developed PTSD due to witnessing violence in the home, or as a result of real or perceived parental abandonment.

After individuals with <a title="Dissociative identity disorder" href="/wiki/Dissociative_identity_disorder">dissociative identity disorder</a>, patients with posttraumatic stress disorder have the highest hypnotizability of any <a title="Clinic" href="/wiki/Clinic">clinical</a> group.<a href="#cite_note-79">[78]</a>