1. Posttraumatic Stress Disorder (PTSD): What is it and what causes it?

2. World War I “Thousand-yard Stare” “Shell Shock”

3. World War II Combat Stress Reaction

4. Vietnam War Veterans Insurance Benefits

5. More than just war Rape victims Severe physical abuse Natural disasters Violent crime victims

6. DSM-III - 1980 PTSD first appears as a formal psychological disorder Reaction to experiences “outside the range of normal human experience”

7. DSM-IV - 1994 (A1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (A2) the person's response involved intense fear, helplessness, or horror.

8. Core Symptoms of PTSD Re-experiencing through intrusive thoughts, nightmares Avoidance Arousal Duration > 1 month Clinically significant distress or impairment in everyday functioning

9. PTSD Prevalence ~ 50% of people experience a traumatic event Most people recover within 2 months (Bonanno, 2004) PTSD prevalence: 7-8% 10-18% of OEF/OIF veterans

10. PTSD Associated with: – Depression – Anxiety disorders – Low life satisfaction – Poor physical health – Poor sleep quality – Cognitive impairments – Anger management – Substance abuse – Marital problems – Distress and suicide ideation in partners

11. PTSD Pre-Trauma Risk Factors: – Female – Prior history of mental problems – Prior history of traumas – Neuroticism – Low IQ – Alcohol/Drug Abuse – Small hippocampi

12. PTSD Peri-Trauma Risk Factors: – Severity of Event – Dissociation

13. PTSD Post-Trauma Risk Factors: – Perceived Social Support – Event Centrality (Trauma as Identity)

14. PTSD Classical Conditioning

15. Treatment of PTSD Exposure Therapy

16. Barriers to Therapy 78% of Iraq war veterans acknowledged a mental health problem, yet only 26% sought treatment (Hoge et al., 2004) “I would be seen as weak” “I don’t trust mental health professionals”

17. Posttraumatic Growth “What Doesn’t Kill You Makes You Stronger” Greater Appreciation of Life Personal Strength Spiritual Growth New Possibilities Relating to Others