EPIDEMIOLOGY

Prevalence and Vulnerability in the General Population

About 7 or 8 of every 100 people in the United States will have PTSD at some point in their lives, and about 8 million adults have PTSD during a given year. However, this number represents only a small portion of those who have gone through a trauma.

About 10 of every 100 women develop PTSD sometime in their lives compared with about 4 of every 100 men (Sareen, 2020; NCPTSD, 2019). The rates of PTSD for men and women are similar after events such as accidents, natural disasters, and sudden death of a loved one, but the incidence of PTSD after rape is higher in men compared to women despite the fact that women are more than 10 times more likely to be raped. The rate of PTSD, however, is lower in men after events such as molestation and physical assault.

Sexual assault is the most frequent type of traumatic event among women with PTSD. Among a representative sample of women in the United States, the lifetime prevalence of PTSD was 12.3%. Of the women who have a history of PTSD, 32% had been raped and 31% were sexually assaulted but not raped (Sareen, 2020).

To date, there have been no population-based epidemiological studies done that examine the prevalence of PTSD among children; however, research indicates that children exposed to traumatic events may have a higher prevalence of PTSD than adults in the general population.

Vulnerability is influenced both by the characteristics of the individual as well as those of the event. Traumas that are intentional have been found to be more closely associated with PTSD than those that are unintentional or nonassaultive (Sareen, 2020).

PTSD and Military Personnel

The number of veterans with PTSD varies by service era. About 20 of every 100 veterans who served during the Iraq and Afghanistan wars have PTSD in a given year. Those who served during the Gulf War have a prevalence of 12 out of every 100 veterans, and those who served during the Vietnam War have a prevalence of 15 out of every 100 veterans. It is estimated that about 30 out of every 100 Vietnam veterans have had PTSD in their lifetime (NCPTSD, 2018a).

PTSD occurring after combat injury develops over several months and correlates with the extent of injury and the occurrence and severity of traumatic brain injury. Nearly 50% of soldiers with combat-related traumatic brain injury met criteria for PTSD (Sareen, 2020).

Another cause of PTSD in the military is military sexual trauma (MST). This includes any sexual harassment or assault, which can happen to both men and women. Among veterans who use Department of Veterans Affairs healthcare services:

• 23 of every 200 women reported sexual assault when in the military
• 55 of every 100 women and 38 of every 100 men have experienced sexual harassment
• Over half of all veterans with military sexual trauma are men
  (VA, 2018)

PTSD and Suicide

PTSD is a common risk factor for suicide. Depression, internalized anger, self-hatred, and perceived burdensomeness have been identified as mediating factors between PTSD and suicide risk.

Veterans have a 21% higher suicide rate compared with the nonveteran population. Among those with the highest risk are soldiers recently discharged from inpatient psychiatric hospitalizations. Rates are higher in junior enlisted soldiers deployed either in their first year of service or in those with less than expected promotion for their rank. Rates were also higher among women than men during deployment, and marriage had a protective effect only during deployment (Roy & Perkins, 2020; Giacomoni, 2018).