Mervin Smucker (2012). Post-Traumatic Stress Disorder: Co-Morbidity & Predictors

1. Mervin Smucker (2012). Post-Traumatic Stress
Disorder: Co-Morbidity & Predictors

2. Likelihood of Suffering PTSD
(Breslau et al., 1998)
%
• Kidnapping 53.8
• Rape 49.0
• Severe physical abuse 31.9
• Sexual abuse (without rape) 23.7
• Severe accidents 16.8
• Shootings 14.3
• Unexpected death of a loved one 10.4
• Death of a child 8.0
• Armed robberies and assaults 7.3
• Witnessing a murder (or severe injuries) 3.8
• Natural Disasters 2.3

3. Psychiatric Comorbidity of PTSD
Significant % of PTSD sufferers meet criteria for
another disorder
Major Depression 48.2%
Alcohol Abuse/Dependence 39.9%
Social Phobia (other studies 10%) 29.7%
Agoraphobia 19.3%
GAD 15.9%
Panic (other studies 31%) 9.7%
OCD and eating disorders 10%
Personality disorders
Traumatic events were reported by > 80% of borderlines
Kessler et al, 1995 Arch Gen Psychiatry, 52:1048

4. Pre-Trauma Risk Factors
• Female gender
• Past psychiatric history
• Reported childhood abuse
• Family psychiatric history.
(Whitney, D., 2002)

5. Peri-trauma PTSD Predictors
• Traumas due to DELIBERATE HUMAN
MALICE (vs. natural or accidental traumas)
• PERI-TRAUMA DISSOCIATION (emotional
disconnection or "zoning out“ during the
traumatic event)

6. Post-Trauma PTSD Predictors
• Lack of social support
• Severity of acute symptoms (in the immediate
aftermath of a trauma)

7. TRAUMA PROTECTIVE FACTORS
Psychological Physical Resources Environmental
Resources Resources
• Good physical
• Adaptive use of coping health
mechanisms • Availability of a
supportive,
• Sense of competence • Intelligence nurturing family
and mastery
environment
• Stable sense of self
• Consistent social-
• Hope and optimism support network
about the future
• Realistic concept of F. Norris, et al, "Risk Factors for Adverse
• Stable friendships
Outcomes in Natural and Human-Caused
death Disasters: A Review of the Empirical
Literature,“ A National Center for PTSD
Fact Sheet, 2002.