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. 2013 Apr 11;8(4):e59236.
doi: 10.1371/journal.pone.0059236. Print 2013.

A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: intentional and non-intentional traumatic events

Patcho N Santiago  1 , Robert J Ursano, Christine L Gray, Robert S Pynoos, David Spiegel, Roberto Lewis-Fernandez, Matthew J Friedman, Carol S Fullerton
Affiliations

A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: intentional and non-intentional traumatic events

Patcho N Santiago et al. PLoS One. .

Abstract

Objective: We conducted a systematic review of the literature to explore the longitudinal course of PTSD in DSM-5-defined trauma exposed populations to identify the course of illness and recovery for individuals and populations experiencing PTSD.

Methods: We reviewed the published literature from January 1, 1998 to December 31, 2010 for longitudinal studies of directly exposed trauma populations in order to: (1) review rates of PTSD in the first year after a traumatic event; (2) examine potential types of proposed DSM-5 direct trauma exposure (intentional and non-intentional); and (3) identify the clinical course of PTSD (early onset, later onset, chronicity, remission, and resilience). Of the 2537 identified articles, 58 articles representing 35 unique subject populations met the proposed DSM-5 criteria for experiencing a traumatic event, and assessed PTSD at two or more time points within 12 months of the traumatic event.

Results: The mean prevalence of PTSD across all studies decreases from 28.8% (range =3.1-87.5%) at 1 month to 17.0% (range =0.6-43.8%) at 12 months. However, when traumatic events are classified into intentional and non-intentional, the median prevalences trend down for the non-intentional trauma exposed populations, while the median prevalences in the intentional trauma category steadily increase from 11.8% to 23.3%. Across five studies with sufficient data, 37.1% of those exposed to intentional trauma develop PTSD. Among those with PTSD, about one third (34.8%) remit after 3 months. Nearly 40% of those with PTSD (39.1%) have a chronic course, and only a very small fraction (3.5%) of new PTSD cases appears after three months.

Conclusions: Understanding the trajectories of PTSD over time, and how it may vary by type of traumatic event (intentional vs. non-intentional) will assist public health planning and treatment.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Median prevalence of PTSD in DSM-5-Experiencing categories of intentional and non-intentional trauma (N = 14 and 21 studies, respectively).
See this image and copyright information in PMC

References

    1. Marchand A, Guay Sp, Boyer R, Iucci S, Martin A, et al. (2006) A randomized controlled trial of an adapted form of individual critical incident stress debriefing for victims of an armed robbery. Brief Treatment and Crisis Intervention 6: 122–129.
    1. Phelps LF, Williams RM, Raichle KA, Turner AP, Ehde DM (2008) The importance of cognitive processing to adjustment in the 1st year following amputation. Rehabilitation Psychology 53: 28–38.
    1. Bonanno GA, Mancini AD (2008) The human capacity to thrive in the face of potential trauma. Pediatrics 121: 369–375. - PubMed
    1. Hobfoll SE, Palmieri PA, Johnson RJ, Canetti-Nisim D, Hall BJ, et al. (2009) Trajectories of resilience, resistance, and distress during ongoing terrorism: the case of Jews and Arabs in Israel. J Consult Clin Psychol 77: 138–148. - PMC - PubMed
    1. Norris FH, Tracy M, Galea S (2009) Looking for resilience: understanding the longitudinal trajectories of responses to stress. Soc Sci Med 68: 2190–2198. - PubMed

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