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Unformatted text preview: Who Develops Posttraumatic Stress Disorder? Emily J. Ozer 1 and Daniel S. Weiss 2 1 University of California-Berkeley School of Public Health and 2 Department of Psychiatry, University of California-San Francisco School of Medicine ABSTRACT— Nearly half of U.S. adults experience at least one traumatic event in their lifetimes, yet only 10% of women and 5% of men develop posttraumatic stress disorder (PTSD). Why this is so is among the most central questions in current PTSD research. This article reviews the current status of knowledge about who develops PTSD, discussing the strengths and weak- nesses of the evidence. We describe the major models used to understand responses to traumatic events, as well as future research directions. We also propose that an exclusive focus on individual differences and individual intervention overlooks opportunities to reduce the prevalence of PTSD by modifying factors at the neighborhood, community, or national level. KEYWORDS— PTSD predictor; dissociation; traumatic event; prevention The response to traumatic stress varies widely, ranging from transient disruption of functioning to the chronic clinical condition known as posttraumatic stress disorder (PTSD). Interest in and knowledge about PTSD increased dramatically after its diagnosis was formalized in 1980, but study of the effects of extreme stress has a long history, primarily focused on the effects of war (e.g., shell shock in World War I) and of sexual assault against women. According to generally ac- cepted criteria, diagnosis of PTSD requires exposure to a traumatic event that causes feelings of extreme fear, horror, or helplessness. Traumatic events are defined as experiences that involve death, se- rious injury, or threat of death. The consequences of this exposure are manifested in three symptom clusters required for diagnosis: invol- untary reexperiencing of the trauma (e.g., nightmares, intrusive thoughts), avoidance of reminders and numbing of responsivity (e.g., not being able to have loving feelings), and increased arousal (e.g., difficulty sleeping or concentrating, hypervigilance, exaggerated startle response). Because PTSD requires the presence of an external event and symptoms linked to this event, it differs from virtually all other psy- chiatric disorders and raises intriguing issues regarding the definition of trauma, the role of individuals’ appraisal of and responses to the event, the implications of a single versus repeated or ongoing expo- sure, and the role of community- and societal-level changes in at- tempting to prevent PTSD. PREVALENCE Results from a nationally representative study indicated that over the life course, 10% of women and 5% of men in the United States ex- perience PTSD (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995)....
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- Fall '08
- Psychology, Psychological trauma, Posttraumatic stress disorder, traumatic event