Man crossing street with large manipulator looming above tethering him to PTSD symptoms

Approximately 13 million adults in the US are estimated to have PTSD^1-3*

Considering the magnitude of patients experiencing PTSD, a broad lens may be needed.

*Based on 2022 population estimates by the US Census Bureau.

Recognizing when a patient may be living with PTSD

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), PTSD is the development of characteristic symptoms after exposure to one or more traumatic events.⁴ All of the diagnostic criteria outlined by the DSM-5 must be met to be diagnosed with PTSD.

PTSD is characterized by the 4 symptom clusters: Intrusion (re-experiencing), persistent avoidance of stimuli, negative alterations in cognitions and mood, and marked alterations in arousal and reactivity.^4,5

This 5-question screening tool can help identify probable PTSD in a primary care setting. Download screener.

Intrusion
(re‑experiencing)

Persistent avoidance

Negative changes in cognitions and mood

Alterations in arousal and reactivity

An Expert’s Insights

Dr. Arash Javanbakht sheds light on common PTSD epidemiology
misconceptions

Many different types of traumatic events can lead to PTSD

The most common trauma types associated with PTSD^6†

†Based on a 2017 analysis of prevalence and distribution of trauma exposure of 51,196 traumatic events by the World Health Organization (WHO) World Mental Health Surveys (2001-2012).

The overall risk of developing PTSD after a traumatic exposure is 4.0%. This risk varies dramatically by trauma type, with the highest risk of 29.5% being associated with sexual relationship violence, and an 11.7% risk being associated with physical abuse by a partner.^6-8†

Taken together, prevalence of trauma exposure and conditional risk of PTSD inform the patient burden across the wider population. Rape and other sexual assault are less common trauma types, but due to their much higher conditional risk, they are associated with a substantial proportion of PTSD cases.^6-8†

Other sources of trauma that can cause PTSD and may be less recognized include major health conditions, health pandemics, and acting as a first responder in an emergency.^9-12

PTSD can develop at any age and across genders and identities

The median age of onset is 23 among US adults^13‡

‡Based on a US face-to-face household survey conducted between February 2001 and April 2003 using the WHO World Mental Health Survey version of the Composite International Diagnostic Interview (n=9282).¹³

Adult women account for 66.4% of the overall PTSD population in the US^14,15§

§Based on US PTSD prevalence estimates from a secondary analysis of the 2012-2013 National Epidemiologic Survey of Alcohol and Related Conditions assessing PTSD in veterans (n=31,119) and civilians (n=32,982),³ and 2018 population estimates from the Census Bureau, VA, and DOD, 2,607,131 male and 7,558,833 female adults were estimated to have PTSD in the US civilian population and 1,368,925 male and 293,256 female adults in the US military population.¹⁴

PTSD can affect all ethnic groups, with prevalence ranging from 8.7% of Blacks, to 7.4% and 7.0% of whites and Hispanics, respectively, to 4.0% of Asian Americans^16,17||

||Based on data analyzed from 34,653 adult respondents to the 2004-2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).

The majority of patients with PTSD (>80%) are in the civilian population rather than the military population^14¶

¶Based on US PTSD prevalence estimates from a secondary analysis of the 2012-2013 National Epidemiologic Survey of Alcohol and Related Conditions assessing PTSD in veterans (n=31,119) and civilians (n=32,982),³ and 2018 population estimates from the Census Bureau, VA, and DOD, 2,607,131 male and 7,558,833 female adults were estimated to have PTSD in the US civilian population, and 1,368,925 male and 293,256 female adults in the US military population.¹⁴

The presence of certain risk factors may influence the likelihood of developing PTSD

Increased risk of PTSD has been associated with a higher odds ratio (OR) in adults in the US with exposure to at least 1 traumatic event^18-20

#Based on a systematic literature review of published (2015-2019) observational studies of PTSD prevalence in the US compared to those factors not being present.

**Based on data aggregated from studies with varying study designs, and underlying populations and statistical methods reported in 13 publications (2015-2019); compared to males; compared to single people.

††Based on data from 34,653 noninstitutionalized adult US residents from the 2004 to 2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions; compared to heterosexuals.

#Based on a systematic literature review of published (2015-2019) observational studies of PTSD prevalence in the US compared to those factors not being present.

††Based on data from 34,653 noninstitutionalized adult US residents from the 2004 to 2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions; compared to heterosexuals.

PTSD patients may experience a wide range of impact

If a patient mentions struggling with multiple aspects of marital, parental, occupational, and social activities, with ongoing struggles and disruptive symptoms, PTSD may be a factor.⁴

Each person’s experience with PTSD may be different, and symptoms may vary.

Lack of support

PTSD directly undermines social support networks, placing a substantial burden on interpersonal relationships²¹

Sexual intimacy

Studies of survivors of childhood sexual abuse suggest problems with intimate relationships in adulthood, including specific difficulties with intimacy and sexual dysfunction^22-25

Workplace effects

Avoidance and negative cognition symptoms are associated with poor performance at work, including difficulty performing duties, with increased absenteeism and reduced productivity²⁶

Cost of healthcare

PTSD has been shown to incur higher costs per individual than heart disease and certain psychiatric mental illnesses¹⁴

Poverty

PTSD is associated with a high economic burden and homelessness, and higher proportions of individuals living below the poverty line report PTSD symptoms compared to those without PTSD^26,27

Shedding light
Confronting the challenges of PTSD

Discover the PTSD landscape

Inside PTSD
Journey into the
pathophysiology

Explore the science

Beyond the trauma
Navigating the symptoms and course of PTSD

See the symptoms

1.
US Census Bureau, Population Division. Estimates of the Total Resident Population and Resident Population Age 18 Years and Older for the United States, Regions, States, District of Columbia, and Puerto Rico: July 1, 2022 (SCPRC-EST2022-18+POP). Release date: December 2022.
2.
US Department of Veterans Affairs. PTSD: National Center for PTSD. How common is PTSD in adults? Accessed December 4, 2023. https://www.ptsd.va.gov/understand/common/common_adults.asp
3.
Lehavot K, et al. Post-traumatic stress disorder by gender and veteran status [published correction appears in Am J Prev Med. 2019 Oct;57(4):573]. Am J Prev Med. 2018;54(1):e1-e9.
4.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. DSM-5™. American Psychiatric Publishing; 2013.
5.
Lancaster CL, et al. Posttraumatic stress disorder: overview of evidence-based assessment and treatment. J Clin Med. 2016;5:E105.
6.
Kessler RC, et al. Trauma and PTSD in the WHO World Mental Health Surveys. Eur J Psychotraumatol. 2017;8(suppl 5):1353383.
7.
Liu H, et al. Association of DSM-IV posttraumatic stress disorder with traumatic experience type and history in the World Health Organization World Mental Health Surveys. JAMA Psychiatry. 2017;74(3):270-281.
8.
Luz MP, et al. Conditional risk for posttraumatic stress disorder in an epidemiological study of a Brazilian urban population. J Psychiatr Res. 2016;72:51-57.
9.
Cordova MJ, et al. Post-traumatic stress disorder and cancer. Lancet Psychiatry. 2017;4(4):330-338.
10.
Nagarajan R, et al. Prevalence of post-traumatic stress disorder among survivors of severe COVID-19 infections: a systematic review and meta-analysis. J Affect Disord. 2022;299:52-59.
11.
Prioux C, et al. PTSD and partial PTSD among first responders one and five years after the Paris terror attacks in November 2015. Int J Environ Res Public Health. 2023;20(5):4160.
12.
Fekadu W, et al. Incidence of post-traumatic stress disorder after road traffic accident. Front Psychiatry. 2019;10:1-7.
13.
Kessler RC, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593-602.
14.
Davis LL, et al. The economic burden of posttraumatic stress disorder in the United States from a societal perspective. J Clin Psychiatry. 2022;83:21m14116.
15.
Kilpatrick DG, et al. National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. J Trauma Stress. 2013;26:537-547.
16.
Roberts AL, et al. Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychol Med. 2011;41(1):71-83.
17.
Alegría M, et al. Prevalence, risk, and correlates of posttraumatic stress disorder across ethnic and racial minority groups in the United States. Med Care. 2013;51(12):1114-1123.
18.
Schein J, et al. Prevalence of post-traumatic stress disorder in the United States: a systematic literature review. Curr Med Res Opin. 2021;37:2151-2161.
19.
Data on file.
20.
Roberts AL, et al. Pervasive trauma exposure among US sexual orientation minority adults and risk of posttraumatic stress disorder. Am J Public Health. 2010;100(12):2433-2441.
21.
Yehuda R, et al. Post-traumatic stress disorder. Nat Rev Dis Primers. 2015;1:15057.
22.
Suomi A, et al. Couple and family therapies for post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2019;12:CD011257.
23.
Cloitre M, et al. Posttraumatic stress disorder, self- and interpersonal dysfunction among sexually retraumatized women. J Trauma Stress. 1997;10:437-452.
24.
Lamoureux BE, et al. Child sexual abuse and adulthood-interpersonal outcomes: examining pathways for intervention. Psychol Trauma. 2012;4:605-613.
25.
Davis JL, et al. The impact of child sexual abuse on adult interpersonal functioning: a review and synthesis of the empirical literature. Aggress Violent Behav. 2000;5:291-328.
26.
Rodriguez P, et al. Assessment of posttraumatic stress disorder-related functional impairment: a review. J Rehabil Res Dev. 2012;49:649-665.
27.
Parto JA, et al. Symptoms of posttraumatic stress disorder among urban residents. J Nerv Ment Dis. 2011;199:436-439.

Approximately 13 million adults in the US are estimated to have PTSD^1-3*