The diagnosis and treatment of post-traumatic stress disorder has come
a long way since the 1970s, with research now showing it is both more
common and more treatable than once thought.
While early doubters dismissed the condition as a Western phenomenon
that arose because researchers pathologized a nonmedical condition,
subsequent research identified physiological changes to the brain
because of extreme trauma and led to the development of a consistent
ability to diagnose the condition, both in Western and other nations.
In fact, while surveys show that 7.8 percent of Americans have
experienced post-traumatic stress disorder (PTSD), the numbers are far
higher in some other nations, particularly those that have experienced
intense violence. In Algeria and Cambodia, for example, which suffered
through long civil wars, 37 percent and 28 percent of their populations,
respectively, have experienced PTSD, studies say.
Keane, a longtime PTSD researcher, Boston University psychiatry professor,
and associate chief of staff for research and development at the
Veterans Affairs Boston Healthcare System, described progress in recent
decades in understanding PTSD during a talk at the Harvard
School of Public Health (HSPH) Tuesday (March 23). Keane delivered
his remarks as part of the Barry
R. Bloom Public Health Practice Leadership Speaker Series,
sponsored by the HSPH Division
of Public Health Practice.
Though rates of PTSD are not as high in the United States as in some
war-torn nations, Keane said surveys show that PTSD is nonetheless a
significant problem. Further, he said, studies show that the numbers and
the levels of disability of those suffering from PTSD are higher than
those of conditions such as major depression and obsessive-compulsive
In the United States, women tend to develop PTSD at higher rates than
men, something Keane said is not fully understood but that may be
related to the personal nature of violence against women. About 60.7
percent of men experience trauma severe enough to potentially trigger
PTSD during their lifetimes, with 8.1 percent of them developing PTSD.
For women, 51.2 percent experience trauma, with 20.4 percent developing
PTSD is caused by an extreme trauma, which Keane described as a
“massively disturbing event” that sparks intense alarm, anger, or
distress. The condition is marked by apprehension and avoidance
PTSD also imposes an economic burden on society, Keane said, with its
sufferers missing 3.6 days a month from work, costing an estimated $3
billion in lost productivity annually.
“Can you imagine trying to hold down a job when you miss one day a
week?” Keane asked.
The biggest cause of PTSD is the sudden and unexpected death of a
loved one, Keane said. In that case, PTSD is different from the normal
grieving that such a loss would cause and is triggered by particularly
horrific or difficult conditions surrounding the death. Other major
causes of the ailment are wartime combat, sexual violence, and community
Those suffering PTSD can feel its effects for decades, Keane said.
Progress in treating the condition has resulted in several therapeutic
approaches and medicines that can help. Keane said he is very hopeful
about the prospects of identifying and treating patients. One of the
biggest challenges, though, is education to raise awareness.
“I am so hopeful,” Keane said. “[We can] turn around a devastating
condition, a costly condition … if we can just get this [information]