About half of all women and 60 percent of all men experience a trauma sometime during their lives, according to the Department of Veterans Affairs, yet a significantly smaller number of people — only about seven to eight percent — will develop post-traumatic stress disorder (PTSD). Although we commonly associate PTSD with returning soldiers, researchers believe another group of Americans is equally prone to the mental health disorder yet much more likely to be ignored: those who endure trauma in their own neighborhoods, sometimes in their very own homes. Recent reports, including city-specific projects, found that victims of non-war-related violence are experiencing symptoms of PTSD at unexpected rates.
For example, a recent study found that two-thirds of about 8,000 inner-city residents of Atlanta had been violently attacked while a full half knew someone who had been murdered; among this population, about one in three had experienced symptoms consistent with PTSD at some point in their lives. “The rates of PTSD we see are as high or higher than Iraq, Afghanistan, or Vietnam veterans,” Dr. Kerry Ressler told ProPublica.
Take Chicago, where the Federal Bureau of Investigation reported 500 murders in 2012 — higher than more populous New York City’s total of 419 murders in that same year. There, researchers conducted a study in Cook County Hospital, where each year roughly 2,000 patients are treated for gunshot injuries, stabbings, and other violent encounters. Screening patients for post-traumatic stress disorder during 2011, researchers found slightly more than four out of ten patients experienced symptoms of PTSD. Significantly, more than half of all gunshot-wound victims reported signs of the mental health disorder.
In the Chicago study, most of those who responded to the survey were men, which resulted in skewed numbers among those reporting mental health symptoms following violent crimes. More general estimates, though, suggest that one in 10 women will develop PTSD sometime during their lives compared to only five percent of men. Among women, a primary cause of PTSD is rape. The number of women who experience rape is unknown; different reports suggest anywhere from 19 percent to 47 percent of all rapes are reported, while researchers' estimates of the total number of women raped each year in the U.S. fall between 302,000 and 2.7 million. Although commonly rape victims suffer from depression and anxiety, PTSD often figures in the mix of psychological issues following rape. Once again, estimates of the number of women rape victims who experience PTSD specifically are inconsistent. That said, even by the most conservative esstimates, as many as half will experience PTSD post-rape.
A trauma may come in the form of any shocking or scary event — a terrifying ordeal that involved physical harm or the threat of physical harm experienced directly or witnessed. A natural response is the reoccurrence of memories and fears in the weeks and months that follow such an event. Normal reaction becomes PTSD, though, when such feelings continue beyond several weeks or when the feelings worsen over time. The Israel Center for the Treatment of Psychotrauma defines three main symptoms of PTSD as:
- re-experiencing (a feeling of the trauma as recurring)
- avoidance (a strong impulse to avoid anything that has to do with the traumatic experience)
- hyper-arousal (constant feelings of alertness, nervousness, and difficulty concentrating)
In terms of neuroscience, the reason a person may develop PTSD has to do with the body's involuntary response to a traumatic event. The natural "fight or flight" response is actually a flood of stress hormones and, in some cases, this deluge can momentarily incapacitate certain areas of the brain (including parts of the cerebral cortex, which creates logical thought). With normal brain function briefly disabled, perception of the event cannot be processed in the usual way and the long-term memory cannot be properly stored. In the future, then, memory of the trauma, which has not been properly tucked away, is not so much recalled as re-lived.
In any given year, about 5.2 million American adults have PTSD. Why is it important to treat PTSD? Certainly it is important to those who suffer as well as to those who care for them. Yet there is another very good reason for providing care to those with PTSD: It might prevent the spread of crime. People who have been hurt are inclined to hurt others; unfortunately in the case of PTSD, grave statistics substaniate this belief. “Having a diagnosis of PTSD also has been shown to be related to perpetrating more types of violence (e.g., physical fights, property damage, using weapons, and/or threats),” note the authors of research published in Clinical Psychology Review, “...as well as higher incidence of owning more handguns and 'combat' type knives, aiming guns at family members, considering suicide with firearms, loading guns with the purpose of suicide in mind, and patrolling their property with loaded weapons.” To ending the pain of a single person can very well stop violence before it happens.
Elbogen EB, Fuller S, Johnson SC, Brooks S, Kinneer P, Calhoun PS, Beckham JC. Improving risk assessment of violence among military Veterans: An evidence-based approach for clinical decision-making. Clinical Psychology Review. 2010.
Reese C, Pederson T, Avila S, Joseph K, Nagy K, Dennis A, et al. Screening for traumatic stress among survivors of urban trauma. J. Trauma Acute Care Surg. 2012.