More on PTSD

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It seems we are reminded every day about posttraumatic stress disorder (PTSD). It reveals itself in soldier suicides, which are occurring in a way that is more than we can bear. Shootings continue. In one city (Chicago), one mother has been so badly traumatized: She has lost four children over the years to street violence.

With all of this going on, it is good to review some of the things we know about PTSD. No doubt there would be a Nobel Prize for someone who found a fully effective treatment for everyone. This may never happen, but there are some things we know that help us to make a realistic assessment about what we know and what we don’t know.

At times it is good to go back to the textbooks to look at the accumulated knowledge of a profession. I will review Abnormal Psychology and Modern Life, by James Butcher, Susan Mineka, and Jill Hooley (Pearson, 2013). Below is how these authors summarize the state-of-the art.

“The first question to ask is ‘Given that someone has been exposed to a traumatic event, “What factors increase the risk of developing PTSD?”‘ One risk factor is being a female. Other individual risk factors—identified through scientific research—include lower levels of social support, neuroticism (having a tendency to experience negative affect), pre-existing depression or anxiety, or a family history of depression, anxiety, alcohol abuse.

“The manner in which people and examine their stress is also relevant. There is an increased risk of PTSD when people believe that their symptoms are a sign of personal weakness, or if they believe that others will be ashamed of them. This latter factor was operative in the development of PTSD symptoms in survivors of the bombing of Hiroshima.

“Conversely, there are also protective factors that can act as a buffer against PTSD. Good cognitive ability seems to be very important. One study collected IQ data from children who were six years old, in Detroit. Those who at age 6 had an IQ in the Above Average Range (about 115) were less likely to have experienced a traumatic event by age 15. Similarly, if they were exposed to trauma by age 17, they were at lower risk for developing PTSD.

“Consequently, these findings suggest that having a higher IQ may be protective against experiencing trauma and developing PTSD–since children who had average or below average IQ scores were at a similar risk for PTSD.

“Looking at the risk factors for PTSD as well as the protective factors might be particularly helpful when there is large-scale trauma affecting hundreds or thousands of person. In this way, those with higher risk may be triaged when it is practically impossible to assess everyone initially at an intensive level of support and treatment.”

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