Editing Post-traumatic stress disorder (section)

=== Trauma ===
{{main|Psychological trauma}}
{{See also|Psychological resilience}}PTSD has been associated with a wide range of traumatic events. The risk of developing PTSD after a traumatic event varies by trauma type<ref>{{cite journal |vauthors=Vieweg WV, Julius DA, Fernandez A, Beatty-Brooks M, Hettema JM, Pandurangi AK |title=Posttraumatic stress disorder: clinical features, pathophysiology, and treatment |journal=The American Journal of Medicine |volume=119 |issue=5 |pages=383–90 |date=May 2006 |pmid=16651048 |doi=10.1016/j.amjmed.2005.09.027|doi-access=free }}</ref><ref>{{Cite book |vauthors=Dekel S, Gilbertson MW, Orr SP, Rauch SL, Wood NE, Pitman RK |veditors=Stern TA, Fava M, Wilens TE, Rosenbaum JF |title=Massachusetts General Hospital comprehensive clinical psychiatry |publisher=Elsevier |year=2016 |isbn=978-0-323-29507-9 |edition=Second |location=London |pages=380–392 |chapter=Trauma and Posttraumatic Stress Disorder |oclc=905232521}}</ref> and is the highest following exposure to [[sexual violence]] (11.4%), particularly [[rape]] (19.0%).<ref name="Kessler_2017">{{cite journal |vauthors=Kessler RC, Aguilar-Gaxiola S, Alonso J, Benjet C, Bromet EJ, Cardoso G, Degenhardt L, de Girolamo G, Dinolova RV, Ferry F, Florescu S, Gureje O, Haro JM, Huang Y, Karam EG, Kawakami N, Lee S, Lepine JP, Levinson D, Navarro-Mateu F, Pennell BE, Piazza M, Posada-Villa J, Scott KM, Stein DJ, Ten Have M, Torres Y, Viana MC, Petukhova MV, Sampson NA, Zaslavsky AM, Koenen KC |title=Trauma and PTSD in the WHO World Mental Health Surveys |journal=[[European Journal of Psychotraumatology]] |volume=8 |issue=sup5 |pages=1353383 |date=2017-10-27 |pmid=29075426 |pmc=5632781 |doi=10.1080/20008198.2017.1353383}}</ref> Men are more likely to experience a traumatic event (of any type), but women are more likely to experience the kind of high-impact traumatic event that can lead to PTSD, such as [[Violence|interpersonal violence]] and [[sexual assault]].<ref name="UK20052">{{Cite book|url=https://www.ncbi.nlm.nih.gov/books/NBK56494/|title=Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care|last=National Collaborating Centre for Mental Health (UK)|year=2005| id =NICE Clinical Guidelines, No. 26|publisher=Gaskell (Royal College of Psychiatrists) |isbn=978-1-904671-25-1|series=National Institute for Health and Clinical Excellence: Guidance}}</ref>

Motor vehicle collision survivors, both children and adults, are at an increased risk of PTSD.<ref name="Lin_2018">{{cite journal |vauthors=Lin W, Gong L, Xia M, Dai W |title=Prevalence of posttraumatic stress disorder among road traffic accident survivors: A PRISMA-compliant meta-analysis |journal=Medicine |volume=97 |issue=3 |pages=e9693 |date=January 2018 |pmid=29505023 |pmc=5779792 |doi=10.1097/md.0000000000009693}}</ref><ref name="Dai_2018">{{cite journal |vauthors=Dai W, Liu A, Kaminga AC, Deng J, Lai Z, Wen SW |title=Prevalence of Posttraumatic Stress Disorder among Children and Adolescents following Road Traffic Accidents: A Meta-Analysis |journal=[[Canadian Journal of Psychiatry]] |volume=63 |issue=12 |pages=798–808 |date=August 2018 |pmid=30081648 |pmc=6309043 |doi=10.1177/0706743718792194}}</ref> Globally, about 2.6% of adults are diagnosed with PTSD following a non-life-threatening traffic accident, and a similar proportion of children develop PTSD.<ref name="Kessler_2017" /> Risk of PTSD almost doubles to 4.6% for life-threatening auto accidents.<ref name="Kessler_2017" /> Females were more likely to be diagnosed with PTSD following a [[Traffic collision|road traffic accident]], whether the accident occurred during childhood or adulthood.<ref name="Lin_2018" /><ref name="Dai_2018" />

Post-traumatic stress reactions have been studied in children and adolescents.<ref>{{cite journal |vauthors=Bisson JI, Berliner L, Cloitre M, Forbes D, Jensen TK, Lewis C, Monson CM, Olff M, Pilling S, Riggs DS, Roberts NP, Shapiro F |title=The International Society for Traumatic Stress Studies New Guidelines for the Prevention and Treatment of Posttraumatic Stress Disorder: Methodology and Development Process |journal=[[Journal of Traumatic Stress]] |volume=32 |issue=4 |pages=475–483 |date=August 2019 |doi=10.1002/jts.22421 |pmid=31283056 |url=http://orca.cf.ac.uk/120985/1/Binder3.pdf |hdl=10852/77258 |s2cid=195830995 |hdl-access=free}}</ref> The rate of PTSD might be lower in children than adults, but in the absence of therapy, symptoms may continue for decades.<ref name="UK2005">{{Cite book |last=National Collaborating Centre for Mental Health (UK) |title=Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care |publisher=Gaskell (Royal College of Psychiatrists) |url=https://www.ncbi.nlm.nih.gov/books/NBK56494/ |year=2005 |url-status=live |archive-url=https://web.archive.org/web/20170908143630/https://www.ncbi.nlm.nih.gov/books/NBK56494/ |archive-date=2017-09-08 |isbn=978-1-904671-25-1 |series=National Institute for Health and Clinical Excellence: Guidance No. 26}}</ref> One estimate suggests that the proportion of children and adolescents having PTSD in a non-wartorn population in a developed country may be 1% compared to 1.5% to 3% of adults.<ref name="UK2005" /> On average, 16% of children exposed to a traumatic event develop PTSD, with the incidence varying according to type of exposure and gender.<ref name="AlisicZalta2014">{{cite journal |vauthors=Alisic E, Zalta AK, van Wesel F, Larsen SE, Hafstad GS, Hassanpour K, Smid GE |title=Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis |journal=The British Journal of Psychiatry |volume=204 |issue=5 |pages=335–40 |year=2014 |pmid=24785767 |doi=10.1192/bjp.bp.113.131227 |url=https://www.zora.uzh.ch/id/eprint/101391/1/BJP-2014-Alisic-335-40.pdf |doi-access=free}}</ref> Similar to the adult population, risk factors for PTSD in children include: female [[gender]], exposure to disasters (natural or man-made), negative coping behaviors, or lacking proper [[social support]] systems.<ref>{{cite journal |vauthors=Lai BS, Lewis R, Livings MS, La Greca AM, Esnard AM |title=Posttraumatic Stress Symptom Trajectories Among Children After Disaster Exposure: A Review |journal=[[Journal of Traumatic Stress]] |volume=30 |issue=6 |pages=571–582 |date=December 2017 |pmid=29193316 |pmc=5953201 |doi=10.1002/jts.22242}}</ref>

Predictor models have consistently found that childhood trauma, chronic adversity, neurobiological differences, and familial stressors are associated with risk for PTSD after a traumatic event in adulthood.<ref>{{cite journal |vauthors=Koenen KC, Moffitt TE, Poulton R, Martin J, Caspi A |title=Early childhood factors associated with the development of post-traumatic stress disorder: results from a longitudinal birth cohort |journal=[[Psychological Medicine]] |volume=37 |issue=2 |pages=181–92 |date=February 2007 |pmid=17052377 |pmc=2254221 |doi=10.1017/S0033291706009019}}</ref><ref>{{cite journal |vauthors=Lapp KG, Bosworth HB, Strauss JL, Stechuchak KM, Horner RD, Calhoun PS, Meador KG, Lipper S, Butterfield MI |title=Lifetime sexual and physical victimization among male veterans with combat-related post-traumatic stress disorder |journal=Military Medicine |volume=170 |issue=9 |pages=787–90 |date=September 2005 |pmid=16261985 |doi=10.7205/MILMED.170.9.787 |doi-access=free}}</ref><ref>{{cite journal |vauthors=Otte C, Neylan TC, Pole N, Metzler T, Best S, Henn-Haase C, Yehuda R, Marmar CR |s2cid=35801179 |title=Association between childhood trauma and catecholamine response to psychological stress in police academy recruits |journal=[[Biological Psychiatry]] |volume=57 |issue=1 |pages=27–32 |date=January 2005 |pmid=15607297 |doi=10.1016/j.biopsych.2004.10.009}}</ref> It has been difficult to find consistently aspects of the events that predict, but [[Dissociation (psychology)#Peritraumatic dissociation|peritraumatic dissociation]] has been a fairly consistent predictive indicator of the development of PTSD.<ref name="Skelton 2012 628–637" /> Proximity to, duration of, and severity of the trauma make an impact. It has been speculated that interpersonal traumas cause more problems than impersonal ones,<ref>{{cite book |vauthors=Janoff-Bulman R |title=Shattered Assumptions: Toward a New Psychology of Trauma |place=New York |publisher=Free Press |year=1992}}{{page needed|date=January 2014}}</ref> but this is controversial.<ref>{{cite journal |vauthors=Scheeringa MS |title=Untangling Psychiatric Comorbidity in Young Children Who Experienced Single, Repeated, or Hurricane Katrina Traumatic Events |journal=Child and Youth Care Forum |volume=44 |issue=4 |pages=475–492 |date=2015 |doi=10.1007/s10566-014-9293-7 |pmid=26213455 |pmc=4511493}}</ref> The risk of developing PTSD is increased in individuals who are exposed to [[physical abuse]], physical [[assault]], or [[kidnapping]].<ref name="Kessler95" /><ref>{{cite journal |vauthors=Liu H, Petukhova MV, Sampson NA, Aguilar-Gaxiola S, Alonso J, Andrade LH, Bromet EJ, de Girolamo G, Haro JM, Hinkov H, Kawakami N, Koenen KC, Kovess-Masfety V, Lee S, Medina-Mora ME, Navarro-Mateu F, O'Neill S, Piazza M, Posada-Villa J, Scott KM, Shahly V, Stein DJ, Ten Have M, Torres Y, Gureje O, Zaslavsky AM, Kessler RC |title=Association of DSM-IV Posttraumatic Stress Disorder With Traumatic Experience Type and History in the World Health Organization World Mental Health Surveys |journal=[[JAMA Psychiatry]] |volume=74 |issue=3 |pages=270–281 |date=March 2017 |pmid=28055082 |pmc=5441566 |doi=10.1001/jamapsychiatry.2016.3783}}</ref> Women who experience physical violence are more likely to develop PTSD than men.<ref name="Kessler95" />

==== Intimate partner and sexual violence ====
{{main|Intimate partner violence}}{{see also|Rape trauma syndrome}}An individual that has been exposed to [[domestic violence]] is predisposed to the development of PTSD. There is a strong association between the development of PTSD in mothers that experienced domestic violence during the [[perinatal]] period of their pregnancy.<ref>{{cite journal |vauthors=Howard LM, Oram S, Galley H, Trevillion K, Feder G |title=Domestic violence and perinatal mental disorders: a systematic review and meta-analysis |journal=[[PLOS Medicine]] |volume=10 |issue=5 |pages=e1001452 |date=2013 |pmid=23723741 |pmc=3665851 |doi=10.1371/journal.pmed.1001452 |doi-access=free }}</ref>

Those who have experienced sexual assault or rape may develop symptoms of PTSD.<ref name="Hoffman20162">{{cite book |title=Williams Gynecology |veditors=Hoffman BL, Schorge JO, Bradshaw KD, Halvorson LM, Schaffer JI, Corton MM |date=2016 |publisher=[[McGraw Hill]] Professional |isbn=978-0-07-184909-8 |edition=3rd}}</ref><ref name="Suris20042">{{cite journal |vauthors=Surís A, Lind L, Kashner TM, Borman PD, Petty F |s2cid=14118203 |title=Sexual assault in women veterans: an examination of PTSD risk, health care utilization, and cost of care |journal=[[Psychosomatic Medicine]] |volume=66 |issue=5 |pages=749–56 |date=2004 |pmid=15385701 |doi=10.1097/01.psy.0000138117.58559.7b |citeseerx=10.1.1.508.9827}}</ref> The likelihood of sustained symptoms of PTSD is higher if the rapist confined or restrained the person, if the person being raped believed the rapist would kill them, the person who was raped was very young or very old, and if the rapist was someone they knew. The likelihood of sustained severe symptoms is also higher if people around the survivor ignore (or are ignorant of) the rape or blame the rape survivor.<ref>{{cite journal |vauthors=Mason F, Lodrick Z |title=Psychological consequences of sexual assault |journal=Best Practice & Research. Clinical Obstetrics & Gynaecology |volume=27 |issue=1 |pages=27–37 |date=February 2013 |pmid=23182852 |doi=10.1016/j.bpobgyn.2012.08.015 }}</ref>

==== War-related trauma, refugees ====
{{See also|Veteran|Refugee health}}
Military service in combat is a risk factor for developing PTSD.<ref name="Shalev 2017">{{cite journal |vauthors=Shalev A, Liberzon I, Marmar C |title=Post-Traumatic Stress Disorder |journal=The New England Journal of Medicine |volume=376 |issue=25 |pages=2459–2469 |date=June 2017 |pmid=28636846 |doi=10.1056/NEJMra1612499}}</ref> Around 22% of people exposed to combat develop PTSD; in about 25% of military personnel who develop PTSD, its appearance is delayed.<ref name="Shalev 2017" />

Refugees are also at an increased risk for PTSD due to their exposure to war, hardships, and traumatic events. The rates for PTSD within refugee populations range from 4% to 86%.<ref>{{cite journal |vauthors=Hollifield M, Warner TD, Lian N, Krakow B, Jenkins JH, Kesler J, Stevenson J, Westermeyer J |title=Measuring trauma and health status in refugees: a critical review |journal=[[JAMA]] |volume=288 |issue=5 |pages=611–21 |date=August 2002 |pmid=12150673 |doi=10.1001/jama.288.5.611}}</ref> While the stresses of war affect everyone involved, displaced persons have been shown to be more so than others.<ref>{{cite journal |vauthors=Porter M, Haslam N |s2cid=41804120 |title=Forced displacement in Yugoslavia: a meta-analysis of psychological consequences and their moderators |journal=[[Journal of Traumatic Stress]] |volume=14 |issue=4 |pages=817–34 |date=October 2001 |pmid=11776427 |doi=10.1023/A:1013054524810}}</ref>

Challenges related to the overall psychosocial well-being of refugees are complex and individually nuanced. Refugees have reduced levels of well-being and a high rate of mental distress due to past and ongoing trauma. Groups that are particularly affected and whose needs often remain unmet are women, older people, and unaccompanied minors.<ref name="UNESCO_2018">{{Cite book |last=[[UNESCO]] |url=https://unesdoc.unesco.org/ark:/48223/pf0000261278 |title=A Lifeline to learning: leveraging mobile technology to support education for refugees |publisher=[[UNESCO]] |year=2018 |isbn=978-92-3-100262-5}}</ref> Post-traumatic stress and depression in refugee populations also tend to affect their educational success.<ref name="UNESCO_2018" />

==== Unexpected death of a loved one ====
Sudden, unexpected death of a loved one is the most common traumatic event type reported in cross-national studies.<ref name="Kessler_2017"/><ref name="Atwoli_2017">{{cite journal |vauthors=Atwoli L, Stein DJ, King A, Petukhova M, Aguilar-Gaxiola S, Alonso J, Bromet EJ, de Girolamo G, Demyttenaere K, Florescu S, Maria Haro J, Karam EG, Kawakami N, Lee S, Lepine JP, Navarro-Mateu F, O'Neill S, Pennell BE, Piazza M, Posada-Villa J, Sampson NA, Ten Have M, Zaslavsky AM, Kessler RC |title=Posttraumatic stress disorder associated with unexpected death of a loved one: Cross-national findings from the world mental health surveys |journal=[[Depression and Anxiety]] |volume=34 |issue=4 |pages=315–326 |date=April 2017 |pmid=27921352 |pmc=5661943 |doi=10.1002/da.22579}}</ref> However, the majority of people who experience this type of event will not develop PTSD. An analysis from the WHO World Mental Health Surveys found a 5.2% risk of developing PTSD after learning of the unexpected death of a loved one.<ref name="Atwoli_2017" /> Because of the high prevalence of this type of traumatic event, unexpected death of a loved one accounts for approximately 20% of PTSD cases worldwide.<ref name="Kessler_2017" />

==== Life-threatening or severe illness ====
Medical conditions associated with an increased risk of PTSD include cancer,<ref name="cancer.gov">{{Cite web |url=https://www.cancer.gov/about-cancer/coping/survivorship/new-normal/ptsd-hp-pdq |title=Cancer-Related Post-traumatic Stress |website=National Cancer Institute |access-date=2017-09-16 |date=January 1980}}</ref><ref>{{cite journal |vauthors=Swartzman S, Booth JN, Munro A, Sani F |s2cid=1828418 |title=Posttraumatic stress disorder after cancer diagnosis in adults: A meta-analysis |journal=[[Depression and Anxiety]] |volume=34 |issue=4 |pages=327–339 |date=April 2017 |pmid=27466972 |doi=10.1002/da.22542 |url=https://discovery.dundee.ac.uk/en/publications/04e54111-8d61-418b-b36b-62fc4b496470 |type=Submitted manuscript|doi-access=free |hdl=20.500.11820/b8651f89-9611-4f50-8766-3d5b64b8be23 |hdl-access=free }}</ref><ref>{{cite journal |vauthors=Cordova MJ, Riba MB, Spiegel D |title=Post-traumatic stress disorder and cancer |journal=The Lancet. Psychiatry |volume=4 |issue=4 |pages=330–338 |date=April 2017 |pmid=28109647 |pmc=5676567 |doi=10.1016/S2215-0366(17)30014-7}}</ref> heart attack,<ref>{{cite journal |vauthors=Edmondson D, Richardson S, Falzon L, Davidson KW, Mills MA, Neria Y |title=Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta-analytic review |journal=[[PLOS ONE]] |volume=7 |issue=6 |pages=e38915 |date=2012 |pmid=22745687 |pmc=3380054 |doi=10.1371/journal.pone.0038915 |bibcode=2012PLoSO...738915E |doi-access=free}}</ref> and stroke.<ref>{{cite journal |vauthors=Edmondson D, Richardson S, Fausett JK, Falzon L, Howard VJ, Kronish IM |title=Prevalence of PTSD in Survivors of Stroke and Transient Ischemic Attack: A Meta-Analytic Review |journal=[[PLOS ONE]] |volume=8 |issue=6 |pages=e66435 |date=2013-06-19 |pmid=23840467 |pmc=3686746 |doi=10.1371/journal.pone.0066435 |bibcode=2013PLoSO...866435E |doi-access=free}}</ref> 22% of cancer survivors present with lifelong PTSD like symptoms.<ref>{{cite journal |vauthors=Abbey G, Thompson SB, Hickish T, Heathcote D |title=A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder |journal=[[Psycho-Oncology]] |volume=24 |issue=4 |pages=371–81 |date=April 2015 |pmid=25146298 |pmc=4409098 |doi=10.1002/pon.3654 }}</ref> Intensive-care unit (ICU) hospitalization is also a risk factor for PTSD.<ref>{{cite journal |vauthors=Davydow DS, Gifford JM, Desai SV, Needham DM, Bienvenu OJ |title=Posttraumatic stress disorder in general intensive care unit survivors: a systematic review |journal=[[General Hospital Psychiatry]] |volume=30 |issue=5 |pages=421–34 |date=September 2008 |pmid=18774425 |pmc=2572638 |doi=10.1016/j.genhosppsych.2008.05.006}}</ref> Some women experience PTSD from their experiences related to [[breast cancer]] and [[mastectomy]].<ref name="ArnaboldiRiva2017">{{cite journal |vauthors=Arnaboldi P, Riva S, Crico C, Pravettoni G |title=A systematic literature review exploring the prevalence of post-traumatic stress disorder and the role played by stress and traumatic stress in breast cancer diagnosis and trajectory |journal=Breast Cancer: Targets and Therapy |volume=9 |pages=473–485 |year=2017 |pmid=28740430 |pmc=5505536 |doi=10.2147/BCTT.S111101 |doi-access=free }}</ref><ref name="Liu e0177055">{{cite journal |vauthors=Liu C, Zhang Y, Jiang H, Wu H |title=Association between social support and post-traumatic stress disorder symptoms among Chinese patients with ovarian cancer: A multiple mediation model |journal=[[PLOS ONE]] |volume=12 |issue=5 |pages=e0177055 |date=2017-05-05 |pmid=28475593 |pmc=5419605 |doi=10.1371/journal.pone.0177055 |bibcode=2017PLoSO..1277055L |doi-access=free}}</ref><ref name="cancer.gov"/> Loved ones of those who experience life-threatening illnesses are also at risk for developing PTSD, such as parents of a child with chronic illnesses.<ref>{{Cite journal |url=http://psycnet.apa.org/record/2009-06704-015 |title=PsycNET |journal=Health Psychology |date=2009 |doi=10.1037/a0014512 |pmid=19450045 |access-date=2018-09-30 |volume=28 |issue=3 |pages=379–388 | vauthors = Cabizuca M, Marques-Portella C, Mendlowicz MV, Coutinho ES, Figueira I }}</ref>

===== Psychosis spectrum conditions =====
Research exists which demonstrates that survivors of [[Psychosis|psychotic episodes]], which exist in diseases such as [[schizophrenia]], [[schizoaffective disorder]], [[bipolar I disorder]], and others, are at greater risk of developing PTSD. This is often due to the experiences one may have during and after psychosis. Such traumatic experiences include, but are not limited to, [[Psychiatric survivors movement|experiences in psychiatric hospitals]], police interactions, social stigma, and embarrassment due to psychotic behavior, suicidal behavior and attempts, distressing delusions and hallucinations, and the fear of losing control or actual loss of control. The incidence of PTSD in survivors of psychosis may be as low as 11% and as high at 67%.<ref>{{cite journal | vauthors = Buswell G, Haime Z, Lloyd-Evans B, Billings J | title = A systematic review of PTSD to the experience of psychosis: prevalence and associated factors | journal = BMC Psychiatry | volume = 21 | issue = 1 | pages = 9 | date = January 2021 | pmid = 33413179 | pmc = 7789184 | doi = 10.1186/s12888-020-02999-x | doi-access = free }}</ref><ref>{{cite journal | vauthors = Shaw K, McFarlane A, Bookless C | title = The phenomenology of traumatic reactions to psychotic illness | journal = The Journal of Nervous and Mental Disease | volume = 185 | issue = 7 | pages = 434–441 | date = July 1997 | pmid = 9240361 | doi = 10.1097/00005053-199707000-00003 }}</ref><ref>{{cite journal | vauthors = Lu W, Mueser KT, Rosenberg SD, Yanos PT, Mahmoud N | title = Posttraumatic Reactions to Psychosis: A Qualitative Analysis | journal = Frontiers in Psychiatry | volume = 8 | pages = 129 | date = 2017-07-19 | pmid = 28769826 | pmc = 5515869 | doi = 10.3389/fpsyt.2017.00129 | doi-access = free }}</ref>

===== Cancer =====
Prevalence estimates of cancer‐related PTSD range between 7% and 14%,<ref>{{Cite journal |last1=Abbey |first1=Gareth |last2=Thompson |first2=Simon BN |last3=Hickish |first3=Tamas |last4=Heathcote |first4=David |date=2014-05-20 |title=A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder. |journal=Journal of Clinical Oncology |volume=32 |issue=15_suppl |pages=e20557 |doi=10.1200/jco.2014.32.15_suppl.e20557 |issn=0732-183X|url=http://eprints.bournemouth.ac.uk/24879/9/A%20meta-analysis%20of%20prevalence%20rates%20and%20moderating%20factors%20for%20cancer-related%20post-traumatic%20stress%20disorder.pdf }}</ref> with an additional 10% to 20% of patients experiencing subsyndromal post-traumatic stress symptoms (PTSS).<ref>{{Cite journal |last1=Andrykowski |first1=Michael A. |last2=Cordova |first2=Matthew J. |last3=Studts |first3=Jamie L. |last4=Miller |first4=Thomas W. |date=1998 |title=Posttraumatic stress disorder after treatment for breast cancer: Prevalence of diagnosis and use of the PTSD Checklist--Civilian Version (PCL--C) as a screening instrument. |journal=Journal of Consulting and Clinical Psychology |volume=66 |issue=3 |pages=586–590 |doi=10.1037/0022-006x.66.3.586 |pmid=9642900 |issn=0022-006X}}</ref><ref>{{Cite journal |last1=Shelby |first1=Rebecca A. |last2=Golden-Kreutz |first2=Deanna M. |last3=Andersen |first3=Barbara L. |date=2008-04-10 |title=PTSD diagnoses, subsyndromal symptoms, and comorbidities contribute to impairments for breast cancer survivors |journal=Journal of Traumatic Stress |volume=21 |issue=2 |pages=165–172 |doi=10.1002/jts.20316 |pmid=18404636 |issn=0894-9867|pmc=2435300 }}</ref> Both PTSD and PTSS have been associated with increased distress and impaired quality of life,<ref>{{Cite journal |last1=Shand |first1=Lyndel K. |last2=Cowlishaw |first2=Sean |last3=Brooker |first3=Joanne E. |last4=Burney |first4=Sue |last5=Ricciardelli |first5=Lina A. |date=2014-11-12 |title=Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis |journal=Psycho-Oncology |volume=24 |issue=6 |pages=624–634 |doi=10.1002/pon.3719 |pmid=25393527 |issn=1057-9249}}</ref> and have been reported in newly diagnosed patients as well as in long‐term survivors.<ref>{{Cite journal |last1=Smith |first1=Sophia K. |last2=Zimmerman |first2=Sheryl |last3=Williams |first3=Christianna S. |last4=Benecha |first4=Habtamu |last5=Abernethy |first5=Amy P. |last6=Mayer |first6=Deborah K. |last7=Edwards |first7=Lloyd J. |last8=Ganz |first8=Patricia A. |date=2011-12-01 |title=Post-Traumatic Stress Symptoms in Long-Term Non-Hodgkin's Lymphoma Survivors: Does Time Heal? |journal=Journal of Clinical Oncology |volume=29 |issue=34 |pages=4526–4533 |doi=10.1200/jco.2011.37.2631 |pmid=21990412 |issn=0732-183X|pmc=3236652 }}</ref>

The PTSD Field Trials for the ''Diagnostic and Statistical Manual, Fourth Edition'' ([[DSM-IV]]), revealed that 22% of cancer survivors present with lifetime cancer-related PTSD (CR-PTSD), endorsing cancer diagnosis and treatment as a traumatic stressor.<ref>{{Cite journal |last1=Alter |first1=Carol L. |last2=Pelcovitz |first2=David |last3=Axelrod |first3=Alan |last4=Goldenberg |first4=Barbara |last5=Harris |first5=Helene |last6=Meyers |first6=Barbara |last7=Grobois |first7=Brian |last8=Mandel |first8=Francine |last9=Septimus |first9=Aliza |last10=Kaplan |first10=Sandra |date=March–April 1996 |title=Identification of PTSD in Cancer Survivors |journal=Psychosomatics |language=en |volume=37 |issue=2 |pages=137–143 |doi=10.1016/S0033-3182(96)71580-3 |doi-access=free|pmid=8742542 }}</ref>

Therefore, as the number of people diagnosed with cancer increases and cancer survivorship improves, cancer-related PTSD becomes a more prominent issue, and thus, providing for cancer patients' physical and psychological needs becomes increasingly important.<ref>{{Cite journal |last1=Dimitrov |first1=Lilia |last2=Moschopoulou |first2=Elisavet |last3=Korszun |first3=Ania |date=2019-04-05 |title=Interventions for the treatment of cancer-related traumatic stress symptoms: A systematic review of the literature |journal=Psycho-Oncology |volume=28 |issue=5 |pages=970–979 |doi=10.1002/pon.5055 |pmid=30847978 |issn=1057-9249|url=https://qmro.qmul.ac.uk/xmlui/handle/123456789/58881 }}</ref>

==== Pregnancy-related trauma ====
{{Main|Childbirth-related post-traumatic stress disorder}}
Women who experience [[miscarriage]] are at risk of PTSD.<ref name=Christiansen2017>{{cite journal |vauthors=Christiansen DM |title=Posttraumatic stress disorder in parents following infant death: A systematic review |journal=[[Clinical Psychology Review]] |volume=51 |pages=60–74 |date=February 2017 |pmid=27838460 |doi=10.1016/j.cpr.2016.10.007}}</ref><ref name="kirs2">{{cite journal |vauthors=Kersting A, Wagner B |title=Complicated grief after perinatal loss |journal=[[Dialogues in Clinical Neuroscience]] |volume=14 |issue=2 |pages=187–94 |date=June 2012 |doi=10.31887/DCNS.2012.14.2/akersting |pmid=22754291 |pmc=3384447}}</ref><ref>{{cite journal |vauthors=Daugirdaitė V, van den Akker O, Purewal S |title=Posttraumatic stress and posttraumatic stress disorder after termination of pregnancy and reproductive loss: a systematic review |journal=[[Journal of Pregnancy]] |volume=2015 |pages=646345 |date=2015 |pmid=25734016 |pmc=4334933 |doi=10.1155/2015/646345 |doi-access=free}}</ref> Those who experience subsequent miscarriages have an increased risk of PTSD compared to those experiencing only one.<ref name="Christiansen2017" /> PTSD can also occur after childbirth and the risk increases if a woman has experienced trauma prior to the pregnancy.<ref>{{cite journal |vauthors=Ayers S, Bond R, Bertullies S, Wijma K |title=The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework |journal=[[Psychological Medicine]] |volume=46 |issue=6 |pages=1121–34 |date=April 2016 |pmid=26878223 |doi=10.1017/s0033291715002706 |doi-access=free|url=https://sussex.figshare.com/articles/journal_contribution/The_aetiology_of_post-traumatic_stress_following_childbirth_a_meta-analysis_and_theoretical_framework/23434271/1/files/41147231.pdf }}</ref><ref>{{cite journal |vauthors=James S |title=Women's experiences of symptoms of posttraumatic stress disorder (PTSD) after traumatic childbirth: a review and critical appraisal |journal=[[Archives of Women's Mental Health]] |volume=18 |issue=6 |pages=761–71 |date=December 2015 |pmid=26264506 |pmc=4624822 |doi=10.1007/s00737-015-0560-x}}</ref> Prevalence of PTSD following normal childbirth (that is, excluding stillbirth or major complications) is estimated to be between 2.8 and 5.6% at six weeks postpartum,<ref name="Olde20062">{{cite journal |vauthors=Olde E, van der Hart O, Kleber R, van Son M |title=Posttraumatic stress following childbirth: a review |journal=[[Clinical Psychology Review]] |volume=26 |issue=1 |pages=1–16 |date=January 2006 |pmid=16176853 |doi=10.1016/j.cpr.2005.07.002 |hdl=1874/16760 |s2cid=22137961 |hdl-access=free}}</ref> with rates dropping to 1.5% at six months postpartum.<ref name="Olde20062" /><ref name="Alder20062">{{cite journal |vauthors=Alder J, Stadlmayr W, Tschudin S, Bitzer J |s2cid=21859634 |title=Post-traumatic symptoms after childbirth: what should we offer? |journal=[[Journal of Psychosomatic Obstetrics and Gynaecology]] |volume=27 |issue=2 |pages=107–12 |date=June 2006 |pmid=16808085 |doi=10.1080/01674820600714632}}</ref> Symptoms of PTSD are common following childbirth, with prevalence of 24–30.1%<ref name="Olde20062"/> at six weeks, dropping to 13.6% at six months.<ref>{{cite journal |vauthors=Montmasson H, Bertrand P, Perrotin F, El-Hage W |title=[Predictors of postpartum post-traumatic stress disorder in primiparous mothers] |journal=Journal de Gynécologie, Obstétrique et Biologie de la Reproduction |volume=41 |issue=6 |pages=553–60 |date=October 2012 |pmid=22622194 |doi=10.1016/j.jgyn.2012.04.010|s2cid=196363612 |url=https://hal-univ-tours.archives-ouvertes.fr/hal-02526438/file/2012_Montmasson_JGYN_VF.pdf }}</ref> [[Emergency childbirth]] is also associated with PTSD.<ref>{{cite book |title=Perinatal Mental Health: a Clinical Guide |vauthors=Martin C |publisher=M & K Pub |year=2012 |isbn=978-1-907830-49-5 |location=Cumbria, England |page=26}}</ref>

==== Natural disasters ====
{{excerpt|Extreme weather post-traumatic stress disorder}}