Post Traumatic Stress Disorder (PTSD) – A Primer on Neurobiology and Management

Posted on:November 29, 2017
Last Updated: April 29, 2024
Time to read: 13–16 minutes

Psychological trauma involves witnessing of a traumatic or life-threatening event directly to yourself or others. The individual is likely to experience intense fear, horror, and helplessness, which can result in a permanent or transient psychological wound characterised by physical, cognitive, emotional and behavioural changes.

The trauma is acute and transient for most and results in minimal functional impairment. Psychological trauma can be classified into 4 clusters of symptoms. These include:

  • Intrusion symptoms– Flashbacks, nightmares, and intrusive thoughts
  • Avoidance – Avoidance of stimuli associated with trauma
  • Negative Alterations in Cognitions and Mood associated with the traumatic event (s) – difficulty recalling important aspects of trauma, emotional detachment etc.
  • Hyperarousal – Hypervigilance, Insomnia, agitation, irritability, impulsivity, and anger

For some, however, the syndrome persists, and this is termed post-traumatic stress disorder (PTSD). A PTSD diagnosis was originally considered a normal response to an extreme situation however the presence of symptoms for an extended period of time beyond one month is indicative of an abnormal adaptation in the brain.

The prevalence of PTSD varies across countries. It occurs in 5-10% of the population and has a 2:1 female to male ratio. The gender bias may be a result of a combination of a greater propensity to lifetime violence exposure and genetic vulnerability (variation in the ADCYAP1R1 (pituitary receptor) gene). [Yehuda et al., 2015]

In military populations, the risk is more significant. For example, 10 years after the Vietnam war the rates of current PTSD went up to 28% in those who had experienced combat exposure. A recent analysis showed that 40 years after the end of the war, 11% of Vietnam veterans are experiencing PTSD symptoms. [Yehuda et al., 2015]

In civilian population samples, the rates vary from 0.2%-3.8%. A number of factors such as social supports, trauma type, and severity affect prevalence.

We covered Complex PTSD in a separate article.