New Risk Factor for PTSD – Worrying

If there is a disorder that characterizes our times, it surely must be post-traumatic stress disorder, or PTSD. The numbers of people affected by PTSD are staggering – approximately 8% of Americans (24.4 million people) are estimated to have PTSD at any given time. As a result, the symptoms have become well documented – reactive behavior triggered by the memory of a previous traumatic event, resulting in panic attacks, nightmares, sleep disorders, becoming easily startled and prone to emotional outbursts, and avoidance behavior.

Many of the risk factors for post-traumatic stress disorder have also become known. PTSD tends to affect about twice as many women as men (possibly because they are more prone to traumatic events such as violence or rape than men). It also appears more often in those who have had mental health problems previously, or who have a family history of such problems, and it tends to affect those who lack a strong “support system” such as family or friends. Naturally, PTSD is more common in combat zones or in high-crime areas, but in reality a traumatic event can happen to anyone, anywhere. What is it that makes some people more able to cope with trauma and move on, while others relive the trauma – often for years – in the form of PTSD? Scientists are interested in pinning down the risk factors for developing PTSD because although they can rarely do anything to prevent the traumatic situations, they might be able to do something to minimize the things that turn those traumatic events into PTSD.

Thus the results of a recent study published in the journal Psychological Medicine are hopeful, because they indicate that a strong risk factor for PTSD is chronic worrying.

Neurotics – those who worry a lot – are more at risk for PTSD

The study findings were based on studying over 1,000 people in Michigan for a period of ten years. The subjects were all interviewed and assessed for their levels of neurotic behavior at the start of the study, and at the three-year, five-year, and ten-year marks. During this ten-year period, approximately 50% the study participants reported having experienced a traumatic event, and 5% of them developed PTSD after the event.

Naomi Breslau, an epidemiology professor at Michigan State University, where the study was performed, explains the issue raised by these two divergent percentages: “So the question is, ‘What’s the difference between those who develop PTSD and the majority who don’t?'” What they found was that those who had scored highly on the tests for neuroticism (and thus were “chronic worriers”) before the traumatic events occurred were far more likely to react to the trauma by succumbing to PTSD.

This makes sense on an intuitive level, because neuroticism is a type of personality behavior in which people experience high degrees of anxiety in response to everyday events, and tend to overreact to those ordinary events. Thus it seems likely that they would do the same thing when dealing with extraordinary – and traumatic – events.

What are the possible benefits from this study’s findings?

Well, first, the length of the study (ten years) made it possible to determine the “timeline” in which PTSD occurred. The neurotic behavior and chronic worrying came first, followed by PTSD after a subsequent traumatic event. This is important because psychologists and mental health professionals could possibly use tests to identify those more likely to experience PTSD and offer extra support to them.

For example, after an earthquake or a flood or some other disaster, if medical professionals were to use the same types of tests for neuroticism used in the study on affected populations, they might be able to determine from the tests which people scored highly on the neuroticism scale, and thus were more likely to develop PTSD. They could then make sure that the more “at risk” people got more care and support than those who scored lower on the “chronic worrier” scale. As Naomi Breslau puts it, “This paper says people who are habitually anxious are more vulnerable. It’s an important risk factor.”

On another, more proactive level, if follow-up research replicates these findings, and the link between chronic worrying and PTSD is confirmed, similar tests could be used in the military or among providers of emergency services to determine who is most fit for duty in combat zones or in trying situations in which traumatic situations are likely to occur. If a chronically neurotic person is going to be at greater risk from trauma, does it really make sense to expose them to those traumas?

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Juliette Siegfried, MPH

Juliette Siegfried, MPH, has been involved in health communications since 1991. Shortly after obtaining her Master of Public Health degree, she began her career at the National Institutes of Health in Bethesda, Maryland. Juliette now lives in Europe, where she launched ServingMed(.)com, a small medical writing and editing business for health professionals all over the world.

Juliette's resume, facebook: juliette.siegfriedmph, linkedin: juliettes, (+31) 683 673 767

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