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Military Health System

Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is a mental health condition that can develop after exposure to a traumatic event, such as a serious accident, combat experience, sexual assault, physical abuse, or natural disaster. Many individuals with PTSD repeatedly re-experience the ordeal as flashback episodes, memories, nightmares, or frightening thoughts, especially when exposed to events that remind them of the trauma.

A diagnosis of PTSD requires exposure to a trauma and the presence of symptoms from four different categories:

Intrusive Memories

  • Intrusive thoughts
  • Nightmares
  • Flashbacks
  • Emotional distress after exposure to traumatic reminders
  • Physical reactivity after exposure to traumatic reminders

Avoidance

  • Trauma-related thoughts or feelings
  • Trauma-related reminders

Negative Thoughts

  • Inability to recall key features of the trauma
  • Overly negative thoughts and assumptions about oneself or the world
  • Exaggerated blame of self or others for causing the trauma
  • Negative affect
  • Decreased interest in activities
  • Feeling isolated
  • Difficulty experiencing positive affect

Hyperarousal

  • Irritability or aggression
  • Risky or destructive behavior
  • Hypervigilance
  • Heightened startle reaction
  • Difficulty concentrating
  • Difficulty sleeping

PTSD is often comorbid with and shares symptoms common to other conditions, such as substance use disorders, depression, anxiety, chronic health conditions, and sleep difficulties. Data available from the Military Health System Data Repository show that in 2019, approximately 1.8 percent of active-duty service members had a PTSD diagnosis.

PTSD is treatable and many people recover with appropriate treatment. The 2017 VA/DOD Clinical Practice Guideline for the Management of PTSD and Acute Stress Disorder (PDF) provides guidance relating to screening for PTSD and recommended treatment options. Providers should also stay apprised of the latest Defense Department policy guidance on PTSD. The Psychological Health Center of Excellence (PHCoE) has created PTSD clinical support tools for providers, patients, and families based on the guidance in the clinical practice guideline. Additionally, the U.S. Department of Veterans Affairs’ National Center for PTSD offers information and tools to help providers with assessment and treatment of PTSD.

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Anyone who has been through a trauma—violent crime, sexual violence, natural disasters, mass shooting, or combat—can develop posttraumatic stress disorder.

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Last Updated: July 06, 2022
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