PTSD vs PTSI

With suicide rates in the U.S. armed forces at record highs, debate is raging about whether changing the name post-traumatic stress disorder (PTSD) to post-traumatic stress injury (PTSI) would help reduce stigma.

Post-Traumatic Stress Disorder has been an accepted diagnosis since 1980. We believe it is time to adopt a new name – Post-Traumatic Stress Injury. PTSI is more accurate, hopeful and honorable.

What is PTSI?

ptsd1
Source Carrington College

PTSI is a biological injury that develops after a person has experienced or witnessed a terrifying event. While many people have difficulty adjusting and coping for a while after a traumatic event, they normally get better with time and don’t develop PTSI. Yet, some people show symptoms of PTSI like flashbacks, nightmares, anxiety and frightening thoughts that get worse and/or last for months or even years, severely interfering with their daily lives.

PTSI can be recognized as biological trauma, it may respond to an approach that reverses or treats biological alteration of the nervous system. The division of the nervous system, which is likely to play a dominant role in the development and maintenance of PTSI, is the sympathetic system.

If biological causes of PTSI are accepted, the utilization of a blockade of the sympathetic system supplying the brain is a cervical sympathetic ganglion injection called Stellate Ganglion Block (SGB), as well as demonstrate possible clinical applications of its use.

Who suffers from PTSI?

Whereas PTSI first became known to the public in relation to war veterans who were unable to fully recover from the horrors they experienced or witnessed in war, the injury can also be triggered by various other traumatic events. Examples include mugging, assault, rape, torture, child abuse, kidnapping, captivity, car accidents, train wrecks, plane crashes, bombings or natural disasters like floods and earthquakes.

It is estimated that almost 260 million people worldwide suffer from PTSI. In the U.S., about 3.5% of adults are being diagnosed with PTSI in any given year. The median age for the onset of the condition is 23. The injury seems to be more prevalent among women than men. Out of the 60% of women who experience at least one traumatic event in their lifetime, about 20% develop PTSI. In comparison, out of the 50% of men who undergo at least one traumatic incident in their life, approximately 8% develop PTSI.

PTSI in the military

ptsi1
Source Carrington College

The incidence of military related PTSI is on the rise, partly due to increased awareness and better detection. The biggest driver, however, is the continued large-scale military mobilizations in response to the socio-political violence of the past decade. The prevalence and profound impact on quality of life urgently demands effective PTSI treatments (7). Although PTSI is the most commonly diagnosed service-related mental disorder among U.S. military personnel returning from Iraq and Afghanistan, an expert panel convened by the Institute of Medicine found little evidence for the efficacy of most currently employed PTSI treatment modalities (8). As noted by Dr. Hoge in a JAMA 2011 editorial, “Current therapeutics have limited effect…current strategies will effectively reach no more than 20% of all Veterans needing PTSI treatment.”

More than a quarter of U.S. Veterans who fought in the War on Terror were diagnosed and treated for the disorder by the Veterans Health Administration between the years 2004 and 2009 alone. Half of the suicides among active duty service members in 2010 were committed by those who fought in the War on Terror. The disorder is most prevalent among those who fought in the Vietnam War, with 30% of combat service Veterans suffering from PTSI. In addition, 10% of Gulf War, 6-11% of Afghanistan and 12-20% of Iraq combatant service Veterans were diagnosed with PTSI.

PTSI in Children

ptsi_children
Source Carrington College

Even more disconcerting, more than 60% of children between the ages 0-17 and 47% of adolescents between the ages 12-17 experienced or witnessed at least one traumatic event in 2008 alone. Almost half of these children experienced physical assault, a quarter witnessed violence, a tenth suffered from maltreatment and 6% of sexual victimization. It is estimated that about 5% of these children meet the criteria for PTSI. Again, girls seem to be more susceptible to PTSI than boys, with 8% of the former and 2% of the latter showing symptoms of the injury. More than a fifth of children raised in foster care are diagnosed with PTSI, mainly triggered by sexual or physical abuse.

 

PTSI and domestic abuse

ptsi_abuse
Source Carrington College

PTSI is also strongly related to domestic abuse. While 25% of women will experience domestic abuse in their lifetime, 8% of men will be physically or sexually abused by their significant other. In total, 85% of domestic violence victims are women. The risk for developing PTSI after experiencing domestic violence is highest among those who suffered through rape (49%), physical assault (32%) and sexual assault (24%).

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