Causes, Risks and Prevalence of PTSD

What Causes PTSD?

The major factor that determines the development of PTSD is the amount of exposure to combat or other life-threatening trauma. Other aspects of a veteran's personal background before and after the war can make him or her vulnerable to PTSD, as discussed below. However, it is traumatic experiences, not any weaknesses or defects in a person, that cause PTSD.

Prevalence

The estimated lifetime prevalence of PTSD among all adult Americans is 7.8%, with women (10.400) twice as likely as men (5%) to meet criteria for PTSD at some point during their lives. This, however, represents a small proportion of those who have experienced a traumatic event (60.7% for men, 51.2% for women).

The findings of the National Vietnam Veterans Readjustment Survey (NVVRS) estimated lifetime prevalence of PTSD among American Vietnam theater veterans is 30.9% for men and 26.9% for women. An additional 22.5% of men and 21.2% of women have had partial PTSD (some symptoms) at some point in their lives. Thus, more than half of all male Vietnam veterans and almost half of all female veterans have experienced clinically significant reactions to traumatic stress.

However, the National Vietnam Veterans Readjustment Survey underrepresented members of certain minorities. Therefore, to more accurately measure the impact of war on Native American, Asian American, and Pacific Islander veterans, the Matsunaga Vietnam Veterans Project (MVVP) was undertaken.

The MVVP report, like its predecessor, focused primarily on prevalence of PTSD, comorbid psychiatric diagnoses, readjustment problems, and clinical utilization. The MVVP has two components:

American Indian and Alaska Natives and

Native Hawaiians and Americans of Japanese Ancestry.

Of all segments of Native American veterans assessed, Northern Plains Indians had the greatest lifetime prevalence of PTSD (57.2%), followed by Southwest American Indians (45.3%). In all population groups, war-zone experience was the best predictor of PTSD prevalence, explaining between 26% and 39% of the variance.

Risk factors

Risk factors that affected the likelihood of developing war-zone-related PTSD included: a family history of substance abuse, physical abuse as a child, a negative relationship with parents, childhood deviant behaviors, lower educational attainment, non-officer status in Vietnam, and heavy combat experience. After the effects of combat trauma were accounted for, American Indian and Alaska Native veterans were no more likely than any other Vietnam veterans to develop PTSD.