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Mervin smucker 2012 - PTSD - Co-Morbidity & Predictors

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

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Mervin smucker 2012 - PTSD - Co-Morbidity & Predictors

  1. 1. Mervin Smucker (2012). Post-Traumatic StressDisorder: Co-Morbidity & Predictors
  2. 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. 3. Psychiatric Comorbidity of PTSD Significant % of PTSD sufferers meet criteria for another disorderMajor 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. 4. Pre-Trauma Risk Factors• Female gender• Past psychiatric history• Reported childhood abuse• Family psychiatric history. (Whitney, D., 2002)
  5. 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. 6. Post-Trauma PTSD Predictors• Lack of social support• Severity of acute symptoms (in the immediate aftermath of a trauma)
  7. 7. TRAUMA PROTECTIVE FACTORSPsychological Physical Resources EnvironmentalResources Resources • Good physical• Adaptive use of coping healthmechanisms • Availability of a supportive,• Sense of competence • Intelligence nurturing familyand mastery environment• Stable sense of self • Consistent social-• Hope and optimism support networkabout the future• Realistic concept of F. Norris, et al, "Risk Factors for Adverse • Stable friendships Outcomes in Natural and Human-Causeddeath Disasters: A Review of the Empirical Literature,“ A National Center for PTSD Fact Sheet, 2002.