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Mervin Smucker (2012). Post-Traumatic Stress
Disorder: Co-Morbidity & Predictors
Likelihood of Suffering PTSD
                      (Breslau et al., 1998)

                                                %
•   Kidnapping                                 53.8
•   Rape                                       49.0
•   Severe physical abuse                      31.9
•   Sexual abuse (without rape)                23.7
•   Severe accidents                           16.8
•   Shootings                                  14.3
•   Unexpected death of a loved one            10.4
•   Death of a child                            8.0
•   Armed robberies and assaults                7.3
•   Witnessing a murder (or severe injuries)    3.8
•   Natural Disasters                           2.3
Psychiatric Comorbidity of PTSD
        Significant % of PTSD sufferers meet criteria for
                       another disorder
Major Depression                                            48.2%

Alcohol Abuse/Dependence                                    39.9%

Social Phobia       (other studies 10%)                     29.7%

Agoraphobia                                                 19.3%

GAD                                                         15.9%

Panic     (other studies 31%)                               9.7%

OCD and eating disorders                                    10%
Personality disorders

          Traumatic events were reported by > 80% of borderlines
      Kessler et al, 1995 Arch Gen Psychiatry, 52:1048
Pre-Trauma Risk Factors


•   Female gender
•   Past psychiatric history
•   Reported childhood abuse
•   Family psychiatric history.


                  (Whitney, D., 2002)
Peri-trauma PTSD Predictors

• Traumas due to DELIBERATE HUMAN
  MALICE (vs. natural or accidental traumas)

• PERI-TRAUMA DISSOCIATION (emotional
 disconnection or "zoning out“ during the
 traumatic event)
Post-Trauma PTSD Predictors
• Lack of social support


• Severity of acute symptoms (in the immediate
  aftermath of a trauma)
TRAUMA PROTECTIVE FACTORS
Psychological            Physical Resources Environmental
Resources                                   Resources
                         • Good physical
• Adaptive use of coping health
mechanisms                                  • Availability of a
                                                                       supportive,
• Sense of competence    • Intelligence                                nurturing family
and mastery
                                                                       environment
• Stable sense of self
                                                                       • Consistent social-
• Hope and optimism                                                    support network
about the future
• Realistic concept of   F. Norris, et al, "Risk Factors for Adverse
                                                                       • Stable friendships
                         Outcomes in Natural and Human-Caused
death                    Disasters: A Review of the Empirical
                         Literature,“ A National Center for PTSD

                         Fact Sheet, 2002.

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Mervin smucker 2012 - PTSD - Co-Morbidity & Predictors

  • 1. Mervin Smucker (2012). Post-Traumatic Stress Disorder: Co-Morbidity & Predictors
  • 2. Likelihood of Suffering PTSD (Breslau et al., 1998) % • Kidnapping 53.8 • Rape 49.0 • Severe physical abuse 31.9 • Sexual abuse (without rape) 23.7 • Severe accidents 16.8 • Shootings 14.3 • Unexpected death of a loved one 10.4 • Death of a child 8.0 • Armed robberies and assaults 7.3 • Witnessing a murder (or severe injuries) 3.8 • Natural Disasters 2.3
  • 3. Psychiatric Comorbidity of PTSD Significant % of PTSD sufferers meet criteria for another disorder Major Depression 48.2% Alcohol Abuse/Dependence 39.9% Social Phobia (other studies 10%) 29.7% Agoraphobia 19.3% GAD 15.9% Panic (other studies 31%) 9.7% OCD and eating disorders 10% Personality disorders Traumatic events were reported by > 80% of borderlines Kessler et al, 1995 Arch Gen Psychiatry, 52:1048
  • 4. Pre-Trauma Risk Factors • Female gender • Past psychiatric history • Reported childhood abuse • Family psychiatric history. (Whitney, D., 2002)
  • 5. Peri-trauma PTSD Predictors • Traumas due to DELIBERATE HUMAN MALICE (vs. natural or accidental traumas) • PERI-TRAUMA DISSOCIATION (emotional disconnection or "zoning out“ during the traumatic event)
  • 6. Post-Trauma PTSD Predictors • Lack of social support • Severity of acute symptoms (in the immediate aftermath of a trauma)
  • 7. TRAUMA PROTECTIVE FACTORS Psychological Physical Resources Environmental Resources Resources • Good physical • Adaptive use of coping health mechanisms • Availability of a supportive, • Sense of competence • Intelligence nurturing family and mastery environment • Stable sense of self • Consistent social- • Hope and optimism support network about the future • Realistic concept of F. Norris, et al, "Risk Factors for Adverse • Stable friendships Outcomes in Natural and Human-Caused death Disasters: A Review of the Empirical Literature,“ A National Center for PTSD Fact Sheet, 2002.

Editor's Notes

  1. Prisioneros de guerra 50% Combatientes del Vietnam 30% Accidentes de tráfico 3- 11%
  2. Prisioneros de guerra 50% Combatientes del Vietnam 30% Accidentes de tráfico 3- 11%
  3. La investigación sobre depresión en personas con TEP ha mostrado respuestas biofisiológicas diferentes a las encontradas en individuos con depresión solamente. Esto podría indicar que la depresión que acompaña al TEP tiene una base diferente a la depresión no asociada con el TEP. Esto tiene implicaciones para el tratamiento porque podría suceder que tratando el TEP, los síntomas comórbidos de depresión (y quizá) de otros transtornos puedan desaparecer. Dar ejemplo de paciente con TEP que vino con problemas de TOC. Intenvención se dirigió a tratar los dos trastornos simultaneamente pero la depresión nunca se trató como tal.