PTSD in Individuals with HIV

Post-traumatic stress disorder (PTSD) has been found to manifest in some individuals with HIV, a sexually transmitted infection that interferes with the body’s ability to fight off other diseases (Katz and Nevid). The severity of PTSD in these individuals with HIV is correlated with greater HIV symptoms, experiencing trauma before the HIV diagnosis, decreased social support, negative life events, and stigma (Katz and Nevid). Of these, stigma was most influential on PTSD symptom development (Katz and Nevid). In other words, perceived stigma against HIV was found to significantly propagate PTSD symptom progression (Katz and Nevid).

One example of such stigma is the individual with HIV is at fault for acquiring the illness, which, simply put, is an unfair assertion (Katz and Nevid). This, in addition to other stigma, could cause the individual to feel ashamed of their condition. It may also lead them to feel or be rejected by family and friends (Katz and Nevid). Furthermore, as alluded to earlier, stigma could also facilitate the formation of PTSD.

Similar to how HIV carries with it stigma, so too does PTSD. In previous posts, we've touched upon potential harmful stigma unfairly tied to PTSD. Some incorrect perceptions of PTSD include the following: the individual is responsible for their mental condition, the individual with PTSD is “dangerous or violent,” or even that the individual is “crazy.” All of these are certainly incorrect, and they're simply nothing more than unfair prejudgments. It is also a possibility that those with HIV and comorbid PTSD, can be challenged by the stigmas of both conditions. In these individuals with both HIV and PTSD, stigma may be even more prominent and debilitating. It may even cause worsening of either or both of these conditions.

There is certainly a lot of harm associated with the stigma of various conditions—both mental and physical. Certainly, it hurts the individual at the receiving end in a variety of ways—by demoralizing them, by causing them to feel rejected, etc. It is, therefore, important that we help the individual by remaining impervious to how others may potentially perceive one’s condition in a negative light. The individual is what matters and as fellow humans, we should seek to better the lives of others. Learning more about one’s condition, including from the individual facing it, could vastly broaden our perspective and could elucidate our concerns, our reservations, and maybe even our fears of a condition we may not know much about.

References

Katz, Stacey, and Jeffrey S. Nevid. "Risk Factors Associated with Posttraumatic Stress Disorder Symptomatology in HIV-Infected Women." AIDS Patient Care and STDs 19.2 (2005): 110-20. Liebertpub.com. Web. 19 May 2015.

PTSD and Sexual Violence

By Joseph Jacob

Despite increased awareness and prevention efforts, sexual violence continues to persist even in this day and age. In addition to physical harm, sexual violence can facilitate the formation of PTSD as well as other mental health conditions in victims. According to literature, around 16% to 60% of victims develop PTSD and while there is a wide gap in the percentage, it is high regardless of what the exact number may be (Ullman and Peter-Hagene).

With that said, a recent study looked at the importance of one's reaction to victims who disclose their experiences with sexual assault (Ullman and Peter-Hagene). According to the study, around 80% of sexual violence victims tell a third party about it (Ullman and Peter-Hagene). The study then suggests how a negative reaction could lead to greater PTSD symptom development in the victim (Ullman and Peter-Hagene). Characteristics of a negative reaction include “blame, taking control of the victim’s decisions, and stigma”—all of which correlate to greater PTSD symptoms in sexual violence victims (Ullman and Peter-Hagene).

Furthermore, the study also found that positive reactions may serve as protective factors against PTSD, although the link between the two is not as well established (Ullman and Peter-Hagene). The results of this study goes to show how important it is to receive someone’s disclosure of being sexually assaulted with sensitivity and compassion.

The study also found that initial PTSD symptoms in the victim could also elicit more negative responses from the individual listening to the victim (Ullman and Peter-Hagene). That is, PTSD symptoms already present in victims could lead to negative responses from the person to whom the victim revealed their sexual assault to. With this, a cycle could be generated that leads to persistent negative responses that further the harms of PTSD (Ullman and Peter-Hagene). So not only does a negative response to a victim disclosing their attack cause PTSD symptoms, but the vice-versa is also true—PTSD symptoms could also garner negative responses from listeners. Again, this can instill a harmful cycle.

With all of this said, there is still much to assess about PTSD, its link to sexual violence, the impact of negative and positive reactions, and what we can do to prevent worsening of the symptoms. However, there is one thing that is apparent—responding to a victim’s disclosure of sexual assault must be in a sensitive, attentive, and gentle manner. If a sexual abuse survivor chooses to trust us enough to talk about their experience, we must be cognizant of how our response could impact the victim. We must be careful in choosing our response, and we should always be supportive and should seek to help the individual. Communication from the victim is good, and if they choose to talk about their attack—which of course is a demanding task in and of itself—the response should only bolster the victim and never the opposite.

References:

Ullman, Sarah E., and Liana C. Peter-Hagene. "Longitudinal Relationships of Social Reactions, PTSD, and Revictimization in Sexual Assault Survivors." Journal of Interpersonal Violence (2014): 1-21. SAGE Publications. Web. 3 May 2015.

Stigma: A Barrier to Care for Citizen Soldiers

By Joseph Jacob

Citizen soldiers (that is, the National Guard and Reserves), like their active duty counterparts, are prone to PTSD and other mental health conditions. Other mental health concerns that may also occur in citizen soldiers, either independently or co-morbidly, include "clinical depression, sleep dysregulation and nightmares, self-medication, substance use and abuse, and suicide thoughts, acts, and occasional tragic deaths by suicide” (Greden et al.). These psychological conditions are a product of the traumas and stresses that these soldiers encounter during their service.

Upon returning from service, soldiers with mental illnesses are reluctant to reaching out for care (Greden et al.). According to a study, a significant barrier was the “inexorable stigma” associated with seeking out treatment (Greden et al.). These soldiers are also challenged by additional barriers or stressors that hinder them from pursuing treatment (Greden et al.). A few examples of these barriers include financial issues, relationship troubles, and separation from military support (Greden et al.).

The same study, using Michigan Army National Guards (MI ARNG) as a prototype for civilian soldiers, looked into the psychological effects of their service (Greden et al.). Of the sample population with a reported mental concerns, only 47 percent pursued help or treatment (Greden et al.). The following table are some of the reasons why individuals from this group restrained from seeking out help:

Retrieved from: http://onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.2010.05719.x/epdf

Clearly, the stigma of their condition played a significant role in deterring these individuals from seeking care (Greden et al.). The study also proposed a peer-to-peer program called Buddy-to-Buddy which essentially tailors mental health care to those returning from service (Greden et al.). The program trains peer soldiers, who are not too distant in military rank, to periodically “check in” on soldiers returning from service (Greden et al.). It permits and facilitates a level of comfort in talking about potential problems these returning soldiers may have, without having them feel disconnected from the listener. The peers are supportive and are more likely to recognize the hardships these returning soldiers face. Upon recognizing any signs, these peer soldiers help returning troops get care (Greden et al.). Furthermore, civilian clinicians are also educated on treating soldiers and being sensitive to their experiences and past (Greden et al.). Coming from similar roles in their service, these peer soldiers are able to relate to the returning soldiers in a way that is difficult with civilian clinicians and/or mental health advisors. The program seems promising as its purpose is to break down barriers such as stigmas.

This program has certainly met previously unmet needs of soldiers (Greden et al.). According to the study, having someone who can relate to the experiences and traumas that one may face during their service may be a key way to break down the stigma of these illnesses (Greden et al.). They can facilitate conversations and could promote an environment of comfort for soldiers—an environment that may not be possible in a civilian clinical setting. More peer-to-peer programs throughout the nation could benefit returning troops and could bring an increase in the amount of soldiers with these mental health concerns who seek treatment for their condition.

References:

Greden, John F., Marcia Valenstein, Jane Spinner, Adrian Blow, Lisa A. Gorman, Gregory W. Dalack, Sheila Marcus, and Michelle Kees. "Buddy-to-Buddy, a Citizen Soldier Peer Support Program to Counteract Stigma, PTSD, Depression, and Suicide." Annals of the New York Academy of Sciences 1208.1 (2010): 90-97. Web.

The Stigma Felt by Soldiers with Combat-PTSD

By Joseph Jacob

Due to the nature of war, combat soldiers are prone to the development of mental health conditions among which include post-traumatic stress disorder (PTSD). PTSD is characterized by “flashbacks, nightmares, severe anxiety, and uncontrollable thoughts following a disturbing event—which could either have been experienced or witnessed by the person” (“Post-traumatic Stress Disorder (PTSD)”). When symptoms intensify or persists for months to years, and when it begins to interfere with one’s functioning, PTSD is likely the diagnosis (“Post-traumatic Stress Disorder (PTSD)”). For a better understanding of the disorder the following link can certainly provide more information regarding the condition: http://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/basics/definition/con-20022540. Although it is a serious mental health issue, it certainly can be improved upon through therapy, medications, and counseling which can all be managed by seeking out health care professionals (i.e. a psychiatrist) (“Post-traumatic Stress Disorder (PTSD)”).

While mental health concerns are common in soldiers, research indicates that only around fifty percent of said soldiers seek out help within one year (Kim et al.). According to a study, stigma as well as barriers to care are prominent reasons as to why these soldiers end up not pursuing treatment and help while facing a mental health condition (Kim et al.). Common stigmas that soldiers felt include being perceived as “dangerous/violent” or even “crazy” (Mittal et al.). Another stigma that demotivated these men and women from seek out help was the notion that combat veterans are at fault and are responsible for the development of PTSD (Mittal et al.). They preferred to remain silent in order to avoid being labeled as someone with a mental illness (Mittal et al.). Being labelled with any disease can bring associated stigmas with it, and this labeling can plant these incorrect stigmas into the minds of others. Remaining silent can, however, be dangerous, as PTSD can "affect quality of life, impairing psychosocial and occupational functioning and overall well-being,” and treatment is crucial for recovery (Schnurr et al.).

Stigma can also have a drastic impact on how soldiers view themselves and it can decrease their self-esteem (Kim et al.). Internalization of these incorrect stigmas only serve to further demoralize these individuals and prevent them from getting treatment. Aside from stigma, barriers to care (i.e. lack of time and a lack of method of transportation) was stated to also play in a role in preventing these individuals from receiving treatment (Kim et al.).

These incorrect stigmas and modes of thinking about PTSD, whether from the general public, military personnel, or even soldiers with PTSD, as is the case in self-stigma (in which they adopt common perceptions about their illness and allow it to define themselves), is certainly detrimental. None of the previously mentioned stigmas are true nor do they do troops any justice. They only serve to exacerbate the mental health condition of the individual and prevent recovery. Thus, it is crucial that stigma is recognized as being harmful never helpful, and discarding these notions from clouding our judgement is only a step forward.

References:

Kim, P. Y., J. L. Thomas, J. E. Wilk, C. A. Castro, and C. W. Hoge. “Stigma, Barriers to Care, and Use of Mental Health Services Among Active Duty and National Guard Soldiers After Combat.” Psychiatric Services 61.6 (2010): 582-88. Web. 12 Apr. 2015.

Mittal, Dinesh, Karen L. Drummond, Dean Blevins, Geoffrey Curran, Patrick Corrigan, and Greer Sullivan. “Stigma Associated with PTSD: Perceptions of Treatment Seeking Combat Veterans.” Psychiatric Rehabilitation Journal 36.2 (2013): 86-92. Web. 12 Apr. 2015.

“Post-traumatic Stress Disorder (PTSD).” Mayo Clinic. Mayo Clinic, 15 Apr. 2014. Web. 11 Apr. 2015.

 Schnurr, Paula P., Carole A. Lunney, Michelle J. Bovin, and Brian P. Marx. “Posttraumatic Stress Disorder and Quality of Life: Extension of Findings to Veterans of the Wars in Iraq and Afghanistan.” Clinical Psychology Review 29.8 (2009): 727-35. Web. 10 Apr. 2015.

The Wounds of the Invisible Warriors

By Kristen O'Neill

Post-traumatic stress disorder has been referred to as a soldier’s “invisible wounds” (“About Us”) from battle, the new fight they face even after returning from war. Dr. Danny Wedding and Dr. Ryan M. Niemiec, two psychologists, write in their book Movies and Mental Illness about twenty-nine movies that show characters with diagnosed PTSD or PTSD-like symptoms. Though most of those films featured veterans and war victims, not one of them featured a female with PTSD. This is despite the fact women are about twice as likely as men to develop PTSD (“PTSD Statistics”).  

When PTSD was first being researched, it focused mainly on the male veterans returning from the Vietnam War. Researchers only looked into PTSD in females in relationship to the behaviors and symptoms shown by female rape victims (“Women, Trauma, and PTSD”). In 2012, over three-thousand sexual assaults were reported to the Department of Defense, 88% of the victims being women (Hlad). Between their increased risk of exposure to trauma due to combat and the risk of sexual assault in the military, servicewomen are put in a situation with two of the triggers commonly associated with causing PTSD. Yet, the National Center for PTSD in 2014 said future research needs to be done to determine the effects of this exposure on women.

So, females in the military are being passed over in Hollywood films that feature the debilitating condition that they are more prone to than their male counterparts. Even science has not done enough research to determine just how much more they are at risk. And now, people are ignoring the plight as even documentaries about soldiers with PTSD feature mostly men. Out of six documentaries specifically focusing on PTSD and adjustment back into civilian life, five of the films featured just men. The last film featured one woman and her struggle (“About the Film”).

With more and more stories coming out about women being sexually assaulted in the military, and the plight of veterans with PTSD gaining more and more exposure, there is no reason for the lack of representation of these invisible warriors in our society. These women have served our country above and beyond and risk so much only to come home scarred. Just as giving young girls role models they can look up to can bolster confidence (Periera), showing these warriors that society has acknowledged their wounds and that they are not alone can make all the difference to a soldier in a dark place.

Works Cited

Hlad, Jennifer. "Does Military Culture Foster Environment of Sex Abuse?" Stripes.com. Stars and Stripes, 23 May 2013. Web. 20 Apr. 2015. <http://www.stripes.com/news/does-military-culture-foster-environment-of-sex-abuse-1.222408>.

"Myths about Posttraumatic Stress Disorder." PTSD Alliance. Web. 19 Apr. 2015. <http://www.ptsdalliance.org/about_myths.html>.

"About Us." Invisible Wound. Web. 19 Apr. 2015. <http://invisiblewound.org/about-us/>.

Wedding, Danny, and Ryan M. Niemiec. "Trauma and Stressor-Related Disorders." Movies and Mental Illness: Using Films to Understand Psychopathology. 4th ed. Boston: Hogrefe, 2014. 108, 110-112. Web. <https://books.google.com/books?id=Zd3sAwAAQBAJ&pg=PP4&lpg=PP4&dq=movies+and+mental+illness+4th+edition&source=bl&ots=dEiNkt1cVC&sig=_7oNpma6aH6EqT0-78A-kIbEAd8&hl=en&sa=X&ei=3Qs0VZaILYO1sATxuYGoBw&ved=0CDoQ6AEwBQ#v=onepage&q&f=false>.

Grohol, John M. "DSM-5 Changes: PTSD, Trauma & Stress-Related Disorders." Psych Central Professional. Psychcentral.com, 28 May 2013. Web. 19 Apr. 2015. <http://pro.psychcentral.com/dsm-5-changes-ptsd-trauma-stress-related-disorders/004406.html>.

"PTSD Statistics." PTSD United. PTSD United, Inc., 2013. Web. 19 Apr. 2015. <http://www.ptsdunited.org/ptsd-statistics-2/>.

Niemiec, Ryan. "About Ryan M. Niemiec." Ryan Niemiec. 2014. Web. 19 Apr. 2015. <http://www.ryanniemiec.com/about.html>.

"Danny Wedding, PhD, MPH: Alumni Directory." Robert Wood Johnson Foundation: Health Policy Fellows. Robert Wood Johnson Foundation. Web. 19 Apr. 2015. <http://www.healthpolicyfellows.org/secure/alumni-bio.php?id=4440>.

"About the Film." HIDDEN BATTLES. VSM Productions. Web. 19 Apr. 2015. <http://hiddenbattles.com/about/>.

Stuever, Hank. "TV Review: HBO's 'Wartorn: 1861-2010' Explores Battles off the Field." The Washington Post 11 Nov. 2010. The Washington Post Company. Web. 19 Apr. 2015. <http://www.washingtonpost.com/wp-dyn/content/article/2010/11/10/AR2010111006971.html>.

Friedman, Matthew J. "PTSD History and Overview." U.S. Department of Veterans Affairs. The National Center for PTSD, 25 Mar. 2014. Web. 19 Apr. 2015. <http://www.ptsd.va.gov/professional/PTSD-overview/ptsd-overview.asp>.

"Not Just a Military Problem: Four Signs You May Have Posttraumatic Stress Disorder."American Foundation for Suicide Prevention. 19 June 2013. Web. 19 Apr. 2015. <https://www.afsp.org/news-events/in-the-news/not-just-a-military-problem-four-signs-you-may-have-posttraumatic-stress-disorder>.

"Women, Trauma, and PTSD." U.S. Department of Veterans Affairs. National Center for PTSD, 3 Jan. 2014. Web. 19 Apr. 2015. <http://www.ptsd.va.gov/public/PTSD-overview/women/women-trauma-and-ptsd.asp>.

Periera, Eva. "The Role Model Effect: Women Leaders Key To Inspiring The Next Generation." Forbes. Forbes Magazine, 19 Jan. 2012. Web. 6 May 2015.

Wedding, Danny, Ryan M. Niemiec, and Mary Ann Boyd. "Appendix F." Movies and Mental Illness 3: Using Films to Understand Psychopathology. 3rd ed. Boston: Hogrefe, 2010. Web. < http://www.hogrefe.com/program/media/flyingbooks/600371/files/600371.pdf>,

There was a Tragedy, Also, PTSD

By Kristen O'Neill

With multiple 24-hour news networks and access to them from any internet enabled device, it’s fair to say that the media has a big influence over Americans. It’s an important responsibility, when a single word can change the tone of a sentence, and consequently the entire article. As a Journalism student at Stony Brook University, I know how important it is to make sure everything I say is as fair and correct as possible. But it seems like the media drops the ball with a topic every now and again. This time, it’s with post-traumatic stress disorder.

In the past few years, soldiers in the military have been involved with various violent crimes and incidents, most recently with the Fort Hood shootings on April 2nd, 2014. A specialist named Ivan Lopez reportedly killed three people and then took his own life following an altercation with another soldier on the base. When news networks began to report, officials were clear in saying that had not yet established a motive and they didn’t know what caused Lopez to do what he did. Yet CNN’s story on the incident mentioned the soldier was being evaluated for PTSD within the first two sentences. The article then says officials have the task of figuring out what in his “background and medical treatment (Sanchez and Brumfield)” could have triggered the shooting. A reader four sentences into the article now knows nothing about the event except that Lopez was suffering from various psychiatric disorders, was being evaluated for PTSD, and he killed people. These associations plant a seed in the reader’s mind that PTSD is associated with violence.

So many news outlets were making this unconscious connection between PTSD and the shooting that the New York Times published an article on April 4th, 2014 about mental health officials concerned with the media’s handling of the Fort Hood incident. Officials were concerned that they were painting those suffering from PTSD as violent, despite a lack of data backing it up and that being dismissed as a possible trigger anyway. Dr. Harry Croft, a psychiatrist, said, “There’s a misconception with PTSD that a symptom is anger and violence” (“Experts Dispel PTSD…”).  

But even after the New York Times ran that story, less than a year later they published an article about an army veteran who was being charged with threatening a shooting in the U.S. capitol. In the first sentence, the veteran is said to be diagnosed with PTSD and has threatened to shoot his wife and others. In the next sentence, we learn the suspect’s name. The story is only 214 words long yet mentions the soldier’s PTSD two more times but not any official motive for the threats (Simpson). Even the most level-headed reader is left to assume that the two must be connected in some way; the article implies that PTSD had something to do with it.

Here’s the problem with these implications and associations. They are not based in fact. Journalists are not psychiatrists, they are not experts in mental health and they don’t have the authority to decide whether a person’s health is connected to their actions – they have to ask questions to figure that out. The fact that these soldiers were suffering from or being evaluated for PTSD is an important fact about them and should be included in the story, just not in the first few sentences, only to be dispelled later in the article. There is a lack of transparency and fairness in reporting about PTSD and it is misleading. As a journalism student, if there’s one thing you don’t want to be, it’s misleading. These media outlets are falling into the stigma and stereotypes of PTSD and in doing so are perpetuating them in the process of reporting.

Works Cited

Simpson, Ian. "Army Veteran Charged With Threatening U.S. Capitol Shooting." The New York Times 5 Feb. 2015. The New York Times. Web. 17 Apr. 2015. <http://www.nytimes.com/reuters/2015/02/05/us/05reuters-usa-maryland-capitol.html?_r=0>.

"Experts Dispel PTSD Link to Violence After Fort Hood Incident." The New York Times 3 Apr. 2014. The New York Times. Web. 17 Apr. 2015. <http://www.nytimes.com/reuters/2014/04/03/us/03reuters-usa-shooting-forthood-health.html>.

Sanchez, Ray, and Ben Brumfield. "Fort Hood Shooter Was Iraq Vet Being Treated for Mental Health Issues." CNN 4 Apr. 2014. CNN. Web. 17 Apr. 2015. <http://www.cnn.com/2014/04/02/us/fort-hood-shooter-profile/>.

Symptoms of Post Traumatic Stress Disorder

By: Jie Hu

          People who suffer from post-traumatic stress disorder (PTSD) tend to find it hard to get through the day because they have problems managing themselves in their daily activities. The many symptoms of the disorder disrupt their lives regularly. In fact, the symptoms of PSTD fall into four different categories.

          The first category involves intrusion symptoms. People experiencing this symptom have recurrent memories of traumatic events. They feel the same degree of fear and horror as they did when the event occurred.  They may also have dissociative reactions during flashbacks of these traumatic events which causes them to lose consciousness. The constant flashbacks can leads to sweating, racing heart rate, and afflicted dreams. They can have repeating nightmares and frightening thoughts. Any sounds, smells, pictures, objects, or even words can trigger the recollection of painful memories.  

          The second category consists of avoidance symptoms. This means avoiding any memories or thoughts that the person may associate with the traumatic event. They may try to avoid any activities, places, objects, or people that could trigger negative memories. For example, a PTSD patient who experienced a natural disaster may avoid watching news or movies involving similar events.

          The third category covers hyperarousal symptoms. Symptoms include extreme difficulty sleeping, eating regularly, and concentrating. This can cause a person to engage in impenetrable behaviors or succumb to unsolicited angry outbursts. Symptoms can also cause the sufferer to act on impulsive thoughts, and do not consider the possibly self-destructive consequences of their actions. They can enter into a state of constant alertness; inspecting their surroundings and searching for any signs of danger.

          The final category of symptoms covers unwarranted negative attitudes towards others. They cannot muster any positive thoughts toward any  person or situation because they perceive everything around them as a danger.  A person may lose confidence and trust in themselves or others. The person might often say, “I am a bad person” or “No one can be trusted”, or “The world is completely dangerous” (American Psychiatric Associations 2013). These thoughts and feelings can throw people into negative emotional states, feeling excessive fear, guilt, shame, and anger. It is common for people to lose interest in hobbies they used to enjoy. It can be hard for them to feel satisfied or happy since they always have negative thoughts.  

          Although there are four main types of PTSD symptoms, PTSD patients can develop other problems as well, such as chronic substance abuse. They may drink alcohol or use drugs in excess to relieve their pain even though this may worsen their symptoms in the long run. According to John Lee’s article “Post Traumatic Stress Disorder and Drug or Alcohol Abuse”, about 25%-75% of people with this disorder developed substance abuse problems. Women are twice as likely to develop this problem as men.

References:

American Psychiatric Associations (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Edition). Washington DC: American Psychiatric Publishing.

John, L. (n.d.). Choosehelp. Retrieved from http://www.choosehelp.com/topics/mental-health/post-        traumatic-stress-disorder-and-drug-or-alcohol-abuse

National institute of mental health. (n.d.). Retrieved from http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/index.shtml

U.s department of veteran affairs. (n.d.). Retrieved from http://www.ptsd.va.gov/public/PTSD-overview/basics/symptoms_of_ptsd.asp

So What is PTSD?

By: Jie Hu

It is natural to feel frightened when a person is in danger. The sense of fear prepares the body to either fight or flight the situation in order to defend oneself from harm. However, for people who have post traumatic stress disorder, the sense of fear and pain is constantly with them even when they are not in danger and they lost the instinct to protect themselves.

Post traumatic stress disorder is a mental health condition caused by terrifying and traumatic events. The person who developed PTSD may be the one who is physically or mentally harmed, witness detrimental events happened to loved ones or non-acquaintance.

This disorder was brought to public attention mainly from battle-scarred soldiers. Other overwhelming life experiences, such as child abuse, rape torture, being kidnapped, car accidents, and any catastrophic incidents, were associated to PTSD.