The likelihood of experiencing a traumatic event in one’s lifetime is quite high. Researchers suggest the lifetime rate of trauma is about 80% (deVries & Olff, 2009). Let’s test this out. Think of 5 of your closest companions or family members. Do not—I repeat: DO NOT ask the following question, but consider whether you might be close enough to know these personal details and take your best guess from what you know:
“Have they ever directly experienced, witnessed someone else experience, or learned of a loved one’s experience of a stressful life event in which there was death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence?”
What was the result? 4 out of 5?
This question is derived from the first criterion, or Criterion A, of the DSM-5 for Posttraumatic Stress Disorder (PTSD). You may see within this question that there are very specific aspects to this criterion of trauma (according to the DSM-5), but when you think of the wide range of experiences that could possibly fall into this criterion you’re looking at a broad range of possibilities. Think: car accidents, natural disasters, unwanted sexual advances, abuse, neglect, domestic violence, or the cumulative effect of grey-area traumatic events (e.g., first responders, military veterans, police officers, bullying, childhood neglect experiences, etc.). So 80% of people experience a “Criterion A trauma”, as we would call it.
Now let’s look at the lifetime prevalence rate for PTSD, or the likelihood that any given person will meet criteria for PTSD at some point in their life. The number is around 7% (deVries & Olff, 2009). That means that 7% of people will at one point in their lifetime meet full DSM-5 criteria for PTSD and could be diagnosed as such. So 80% vs. 7%— what does it all mean, Dr. Lindsey? It means that simply having a criterion A trauma, or experiencing trauma, isn’t enough to have PTSD! There are SEVEN other criteria that also need to be met. They are as follows:
criterion B: symptoms of intrusion (e.g., nightmares, memories, flashbacks)
criterion C: avoidance (e.g., avoid trauma thoughts/feelings or external triggers)
criterion D: negative alterations in cognitions and mood (e.g., guilt/blame, negative worldview, memory issues, negative affect, isolation)
criterion E: alterations in arousal and reactivity (e.g., hypervigilance, jumpiness, irritability, risky behavior, sleep and concentration problems)
criterion F: symptoms must be present for at least 1 month
criterion G: symptoms create distress or functional impairment
criterion H: symptoms are not due to medication, substance use, or other illness
As you can see it actually takes quite a bit of symptoms—of a particular combination— to receive a diagnosis of PTSD. And a diagnosis of PTSD is not the be all, end all. You can have a remission of symptoms to the degree that it no longer causes impairment and POOF the diagnosis is gone. It’s not a once PTSD always PTSD.
However, it is not always easy to see symptoms remit. The good news is we have excellent evidence-based treatments that really work. Research recommends a combination of psychoactive medications and behavioral therapy. Going to see a psychologist who specializes in Trauma and PTSD is one way to start getting the help you need.
Ask your doctor or psychologist for an assessment if you suspect you may meet criteria for PTSD. If you don’t have one, feel free to reach out on my contact page—I have expertise in the assessment and treatment of PTSD and love to help folks find the answers they need to get healthy.
And stay tuned for my next blog post where I’ll talk about what other types of problems trauma can engender. In the meantime, look up the word “multifinality” to get a head start and leave a comment below if you have more questions or want to start a conversation.
be well.