The vast majority of people have heard of Post-Traumatic Stress Disorder (PTSD) before when it comes to veterans and soldiers. Also, we know this mental health condition involves flashbacks, intrusive memories and panic attacks, but beyond that a lot of laypeople don’t know that much about Post-Traumatic Stress Disorder. I’m only starting to learn more about PTSD because I have it because of my sexual assault, so whilst I don’t talk about it in this episode, my own experiences make this important to look at. Therefore, in this clinical psychology podcast episode, we’ll be looking at what is Post-Traumatic Stress Disorder, what causes Post-Traumatic Stress Disorder and what are the symptoms of PTSD. I won’t cover treatments for Post-Traumatic Stress Disorder in this episode because that’s a massive area and I’ve already spoken about that in different episodes on the podcast previously. So if you enjoy learning about mental health, trauma and clinical psychology then this is a great episode for you.
Today’s psychology podcast episode has been sponsored by Cognitive Psychology: A Guide To Neuroscience, Neuropsychology and Cognitive Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
What Is Post-Traumatic Stress Disorder?
As you can imagine Post-Traumatic Stress Disorder is a mental health condition classed as a trauma and stress-related disorder that can develop in response to being exposed to an event or ordeal where severe physical harm or death was threatened or happened. People can develop PTSD after rape, violence, bombings, shootings, military service and rescue workers can develop PTSD too.
In terms of prevalence rate, I talk more about Post-Traumatic Stress Disorder in sexual violence populations briefly in a moment, but about 6.8% of Americans develop the condition in their lifetime. This information is from the National Institute of Mental Health.
Furthermore, Post-Traumatic Stress Disorder can develop at any age, including childhood, and women are more likely to develop it than men. Also, there is some evidence that PTSD runs in families, as well as Post-Traumatic Stress Disorder is often comorbid with conditions like depression, anxiety and substance use disorders. Then when these other conditions can be diagnosed and treated, the likelihood of the overall treatment being successful increases.
In addition, something we need to know about Post-Traumatic Stress Disorder is you can only get diagnosed with the condition if you have PTSD symptoms for over a month. If you have the symptoms for less than a month then you don’t have PTSD (at least in diagnosis terms), instead you have Acute Distress Disorder.
Also, with the right care and support, a lot of PTSD symptoms can abate within trauma survivors within that first month so a lot of people never go on to develop Post-Traumatic Stress Disorder.
Interestingly, Post-Traumatic Stress Disorder can be delayed in its manifestations because this occurs if PTSD symptoms show themselves six months or more after the onset of the trauma.
Post-Traumatic Stress Disorder And The Military
I couldn’t really do a Post-Traumatic Stress Disorder-focused podcast episode without talking about the military as this is where a lot of our common knowledge about PTSD comes from.
The prevalence rate of Post-Traumatic Stress Disorder in the military is moderately high because about 30% of the Vietnam War veterans developed PTSD, and 10% of soldiers who took part in Operation Desert Storm (the Gulf War) developed PTSD. As well as between 12% and 20% of soldiers serving in the Iraq war developed PTSD too.
As you can imagine, it is the combat element that increases the risk of developing Post-Traumatic Stress Disorder for veterans amongst other mental health conditions, because severe harm and death happens around them. There are other risk factors too, including the politics surrounding the war, the type of enemy the soldier faces and where the war is fought.
All these risk factors can interact to cause Post-Traumatic Stress Disorder to develop and be maintained in a soldier.
Moreover, there is a type of trauma that is never spoken about in the military and this is Military Sexual Trauma and sexual assault or sexual harassment connects to this topic too. This certainly can cause Post-Traumatic Stress Disorder.
Since Military Sexual Trauma can happen to both men and women regardless of whether it’s wartime, peacetime or during training with figures suggesting 23% of women have been sexually assaulted in the US military and 55% of women and 38% of men have been sexually harassed in the military too.
Personally, I suspect the real numbers are a lot, lot higher because no one likes to report this stuff and get it on public record. And I say this as a survivor myself, the people that made this research possible are amazing and a lot more courageous than me.
Overall, there are a lot of different traumatic experiences that can lead to a person developing Post-Traumatic Stress Disorder. Including terrorist attacks, natural disasters, sexual assaults and physical attacks.
Post-Traumatic Stress Disorder And Sexual Violence: Why Am I Talking About PTSD Now?
A few weeks ago leading up to Canterbury Pride in early June, I wanted to go by myself to a Warhammer event at my university with a Pride twist. I would be going alone and I wanted to go because it would be nice to meet new people, get back into Warhammer and it would be a good event. Yet I had a lot of social anxiety, I felt physically sick about going and I had seen photos of the Warhammer group at my university and some of the people there were rather triggering for me.
A lot popped up that week because of me wanting to go to this event.
I was really distressed so I texted my best friend and they mentioned I have PTSD, so I pooed-pooed. I wasn’t listening to them, not that they knew it at the time. Yet I thought about it, researched it a little more and then found out it is very common amongst survivors of sexual violence.
This was hammered home last week too when I went to Wales because in the evening, my parents were asleep on the sofa and I was still watching the crime drama that had on and it turned out the killer was getting revenge on her rapists. And the programme showed the implicated rape scenes, so I got really distressed, I couldn’t change the TV over so I shouted and it was a little messy.
There are other reasons why I’m certain I have PTSD and I’ll probably sprinkle them in throughout the episode to help show examples of this in real life.
Anyway, the reason why I’m talking about Post-Traumatic Stress Disorder now is I want to understand it is more and it is scarily common. For example, Campbell (2009) who looked at studies dating back to the 1980s found that between 17% and 65% of women who experience sexual assault develop PTSD. As well as a peer-reviewed article from the University Of Washington School Of Medicine/Uw Medicine found 81% of survivors had PTSD one week after their attack and 75% of sexual assault survivors had PTSD a month after their attack. Lastly, an article from Verywell Mind in 2023 explained nearly 48% of survivors had PTSD after a year of being assaulted.
I want to note that the specific type of Post-Traumatic Stress Disorder that sexual violence survivors develop is known as Rape Trauma Syndrome.
So now we understand how common it is in another area besides military veterans, let’s explore the symptoms of Post-Traumatic Stress Disorder in more depth.
What Are The Symptoms Of Post-Traumatic Stress Disorder?
A lot of people with Post-Traumatic Stress Disorder tend to relive and re-experience the traumatic event or different aspects of it. There is a wide range of triggers, something I am finding out more and more, but there are some common themes. For example, anniversaries of traumatic events and similar people, situations or places can trigger the distressing memories.
A similar person example for me was my attacker was very fat and very overweight so I can be extremely triggered when I see a fat man. This isn’t me being fatphobic, it is just fat people trigger my rape memories.
In addition, Post-Traumatic Stress Disorder causes a person to experience flashbacks, intrusive thoughts, distributed sleep, anxiety, sadness, intense guilt, emotional numbness, outbursts of anger and dissociative experiences.
And whilst people with PTSD try to avoid situations that remind them of the traumatic event, they can still be surprised by what triggers them and when the symptoms last for longer than a month, a diagnosis of PTSD might be relevant.
Now I want us to look at the different types of PTSD symptoms.
What Are The Avoidance Symptoms Of PTSD?
Because no one with Post-Traumatic Stress Disorder wants to be reminded of the traumatic event, we all avoid certain triggers so avoidance symptoms include:
· Avoiding activities, places and people associated with the event
· Avoiding conversations, feelings or thoughts about the event
As I mentioned earlier, I avoid fat men like the plague because they remind me too much of my rapist, and I avoid any crime drama with a sexual violence theme. Thankfully, I never watched Law and Order: Special Victims Unit.
What Are The Reexperiencing Symptoms Of Post-Traumatic Stress Disorder?
When it comes to the reliving the traumatic experience over and over again, symptoms include:
· Experiencing intense emotions when you’re reminded of the event
· Feeling or behaving as if the event was actually happening all over again (flashbacks)
· Having distressing memories and bad dreams of the event
· Having dissociative reactions and/ or loss of awareness of your present surroundings
· Having intense physical sensations when reminded of the event. Such as, feeling faint, feeling a loss of control, sweating, pounding heart and so on.
One of the ways I’ve experienced these symptoms include very distressing physical sensations all over my body about how he was touching and doing things to me, and that’s all I’ll say about that one. As well as I used to have this one a lot more but it has thankfully mellowed out a little nowadays, I would have a complete loss of awareness that worked with these physical sensations so I would need to use grounding techniques to get me to focus back on the present.
What Are The Reactivity and Arousal Symptoms Of PTSD?
When it comes to the reactivity and arousal symptoms of Post-Traumatic Stress Disorder, they can include:
· Feeling easily startled.
· Excess awareness (also known as hypervigilance)
· Sleeping difficulties including having trouble falling or staying asleep
· Difficulty concentrating
· Outbursts of anger or being irritable
An unfortunately good example of this area for me was during my Statistic Theory online exam in May. Since it was bad enough that I couldn’t concentrate enough to do any revision whatsoever until a week before the exam, as well as because the exam was online and made up of 40 multiple choices, my mind wondered after question 20. Which led to a full-on meltdown and panic attack during my exam.
That wasn’t nice but thankfully I passed, only by 3 points by still.
What About The Mood and Cognitive Symptoms Of Post-Traumatic Stress Disorder?
When someone has PTSD, they’ll experience negative changes in their mood and thoughts, these symptoms can include:
· An inability to experience positive moods
· A lack of interest in social activities
· Feeling detached and numb from things
· Having difficulty remembering an important part of the traumatic event
· Pessimism about the future
In terms of clinical psychology, one thing I do want to mentiom is you can see why depression and anxiety are common conditions to find alongside PTSD. For example, a lack of interest in social activities and pessimism about the future, they’re both common with depression too.
Going back to personal experience, I’ve already mentioned the social anxiety I have about going to something new and I have basically stopped that now, and even social events I’ve been going to since before my assault. It still takes me a while to actually go to them before I do. For example, I am not that ashamed to admit, I spent twenty minutes in the university toilets with my social anxiety before I went to a social last week.
Are There Other Symptoms Of Post-Traumatic Stress Disorder?
Some other symptoms of PTSD that don’t really fit into the other categories include:
· Depersonalisation- feeling like you’re outside of your body
· Derealisation- experiencing unreality of surroundings
These symptoms are rarer for people but some clients can experience them.
What Causes Post-Traumatic Stress Disorder?
Whilst we don’t know the definitive cause of Post-Traumatic Stress Disorder, we know that there are biological, psychological and social factors that interact together to develop the condition. Since Post-Traumatic Stress Disorder causes changes in how the body responds to stress so it impacts our stress hormones as well as neurotransmitters that carry information between our nerves.
As a result, people who experience childhood abuse or other traumatic experiences are likely to develop PTSD months or even years after the trauma. Also, temperamental variables, like externalising behaviours or other anxiety difficulties, can increase the risk of developing the condition too.
Additionally, environmental factors can cause PTSD. For instance, childhood adversity, family dysfunction, family mental health history, cultural variables, and more importantly, the more traumatic the event, the greater the risk of developing Post-Traumatic Stress Disorder. This is why witnessing atrocities and severe personal injury are major, major risk factors.
Moreover, having maladaptive coping mechanisms, a lack of social support, financial stress and family instability can all worsen the mental health outcomes for people with Post-Traumatic Stress Disorder.
Personally, because my best friend is the only social support I actually have since my sexual assault because other people just don’t know how to help me and the most important people in my life just want to pretend it never happened and I am perfectly fine. I am seriously not. That can decrease my mental health a lot because I feel guilt towards my best friend because they are all I’ve got until my specialise counselling starts and my best friend isn’t always around, so I have had to do some maladaptive coping mechanisms just to survive.
Having more social support is critical when it comes to PTSD.
On the other hand, there are resilience factors that can decrease the risk of a client developing Post-Traumatic Stress Disorder. Some of these resilience factors are present before the trauma and other resilience factors can become more importantly learnt during and after the traumatic event. For example, seeking out support including mental health professionals, finding a support group, feeling good about your own actions in the face of danger, being able to act and respond effectively despite fear and having a coping strategy are all resilience factors that can help reduce the development of Post-Traumatic Stress Disorder.
Clinical Psychology Conclusion
We’ve covered a lot of ground when it comes to Post-Traumatic Stress Disorder because we’ve looked at what is PTSD, how common is PTSD in the military and sexual violence survivors, what are the symptoms and what are the causes. After this episode, we’ve all deepened our knowledge about this mental health condition a lot and I’m pleased that we’ve all learnt about PTSD more.
Since PTSD is a horrible, horrible condition to have but there is hope. There are treatments and you can still live a long, happy life with the condition.
Even though I’ve been having panic attacks, distressing memories, distressing physical experiences and so on, there are still happy, joyful moments. Like I love spending time with my best friend, I enjoy Outreach work at my university and I still love writing. There are moments of positivity so I focus on them.
And another reason why I liked today’s episode is that I could start to see what I’m experiencing is normal and it’s a natural response to an extremely unnatural situation.
I am not a problem and no one with PTSD is a problem.
Therefore, I want to conclude this episode by saying that if you ever meet, become friends with or get to know someone with PTSD. Offering them some social support (that accurately reflects the level of friendship of course), listening to them and signposting them to some mental health services could have a massive positive impact on that person.
And it really could change their life for the better.
I really hope you enjoyed today’s clinical psychology podcast episode.
If you want to learn more, please check out:
Cognitive Psychology: A Guide To Neuroscience, Neuropsychology and Cognitive Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.
Have a great day.
Clinical Psychology References and Further Reading
American Journal of Psychiatry
Annual Review of Psychology
Au, T. M., Dickstein, B. D., Comer, J. S., Salters-Pedneault, K., & Litz, B. T. (2013). Co-occurring posttraumatic stress and depression symptoms after sexual assault: A latent profile analysis. Journal of affective disorders, 149(1-3), 209-216.
Biological Psychiatry
Brown, A. L., Testa, M., & Messman-Moore, T. L. (2009). Psychological consequences of sexual victimization resulting from force, incapacitation, or verbal coercion. Violence against women, 15(8), 898-919.
Campbell, R. (2009). Trauma, Violence, & Abuse, Vol. 10, No. 3.
Canadian Journal of Psychiatry
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
Dworkin, E. R., Menon, S. V., Bystrynski, J., & Allen, N. E. (2017). Sexual assault victimization and psychopathology: A review and meta-analysis. Clinical psychology review, 56, 65-81.
Hippocampal Volume in Women Victimized by Childhood Sexual Abuse.
https://www.eurekalert.org/news-releases/630084
https://www.psychologytoday.com/us/conditions/post-traumatic-stress-disorder
https://www.verywellmind.com/symptoms-of-ptsd-after-a-rape-2797203#toc-symptoms-of-ptsd-after-sexual-assault
Journal of Psychopharmacology
Journal of Traumatic Stress
Mohammed, G. F., & Hashish, R. K. (2015). Sexual violence against females and its impact on their sexual function. Egyptian Journal of Forensic Sciences, 5(3), 96-102.
National Center for PTSD, U.S. Department of Veterans Affairs
National Comorbidity Survey Replication
National Institute of Mental Health
National Institutes of Health - National Library of Medicine
O’Callaghan, E., Shepp, V., Ullman, S. E., & Kirkner, A. (2019). Navigating sex and sexuality after sexual assault: A qualitative study of survivors and informal support providers. The Journal of Sex Research, 56(8), 1045-1057.
Panisch, L. S., & Tam, L. M. (2020). The role of trauma and mental health in the treatment of chronic pelvic pain: a systematic review of the intervention literature. Trauma, Violence, & Abuse, 21(5), 1029-1043.
Psychiatric Clinics of North America
US Department of Health and Human Services
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