Post-Traumatic Stress Disorder

Byron Simoneaux, Ph.D.

Arkansas Veterans Affairs Psychologist

Posttraumatic Stress Disorder is quickly becoming one of the most visible psychological disorders in the news and social media. Such exposure has provided a dynamic perspective on PTSD. The ever-changing perception of this condition can create problems for people who suffer with it including social stigma and the misinformation of the public, among others. This is not an ideal circumstance as the mental health community endeavors to understand how trauma impacts the individual human experience, interpersonal relationships, and society. Fortunately, public awareness of PTSD has emphasized the need to develop better methods for disseminating information, more effective treatments, and more powerful research. This is partly because children and military veterans, both politically sensitive demographic categories, are particularly vulnerable to traumatic events. 

Trauma is not as uncommon as it has been thought to be in the past.  Estimates suggest that as much as half the population will have an experience that meets the criterion for a traumatic event within the more extensive diagnostic criteria for PTSD. In other words, a traumatic event is not necessarily an “abnormal event.” Less than ten percent of people will eventually develop symptoms that meet criteria for the full diagnosis. Vulnerability is increased if one is exposed to multiple traumatic events, is a female, and/or is a military/combat Veteran. Children have a high risk of being exposed to trauma as well. Researchers have suggested that the majority of children experience some type of trauma, though there is disagreement about how trauma should be defined as it pertains to children. Less than one half of one percent of these children eventually met criteria for being diagnosed with PTSD. All of this is to say that trauma is prevalent and serious, but is not the sole criterion for diagnosing Posttraumatic Stress Disorder. 

The criteria for PTSD have changed with the recent revisions to the diagnostic manual. These changes will require that researchers and clinicians evaluate, treat, and study PTSD differently.  It has yet to be seen how the changes will influence these areas. This will be the case any time diagnoses are changed or criteria are reworded. Those of us that study, teach about, and treat PTSD should prepare to encounter the impact of these changes with the intent to develop the most effective, scientific approach possible to this disorder. 

Currently, there are several treatment options that are supported by evidence. Cognitive-Behavioral treatments and Exposure-based techniques are among those considered evidence-based. The National Center for PTSD and the Veterans Administration are at the forefront of studying and treating PTSD. They endorse Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy (PE), and Eye-Movement Desensitization and Reprocessing (EMDR) for treating PTSD in Veterans and civilian adults. The VA continues to strive to make these treatment approaches available to as many Veterans as possible. Acceptance and Commitment Therapy (ACT), Seeking Safety, and a few others also have evidence supporting their use with adults and Veterans. Trauma-Focused Cognitive Behavioral Therapy and a few other treatments have demonstrated effectiveness in the treatment of PTSD in children and adolescents.    

The Psychology community plays an integral role in the future of PTSD. We are uniquely positioned to develop the most accurate explanations possible for what happens to individuals and groups after traumatic events. If we adhere to the scientific principles upon which our discipline was established, better information will naturally lead to new and more effective treatments.  The influence of psychologists is vital as we learn about posttraumatic stress, treat clients whose problems appear to stem from traumatic events, and teach the next generation of clinicians. What is known about PTSD does not constitute a complete understanding of the effects of psychological trauma. Nevertheless, the information available suggests that the effects can be devastating. Our best efforts will constitute a growing source of hope for those whose lives have been affected by trauma. 

-Byron Simoneaux, Ph.D.