Criminal offending covers a wide range of behaviours including destructive acts, stealing, assault, and abuse. Such behaviour interferes with a person’s continuity of treatment, and increases the burden on patients, their caregivers, and society in general. Identifying factors associated with criminal offending may lead to early identification of those most at risk and preventative interventions.

What is the evidence for criminal offending in people with PTSD?

Moderate quality evidence found increased rates of domestic violence in veterans with PTSD compared to veterans without PTSD, although the evidence is very inconsistent.

Moderate to high quality evidence found no differences in rates of criminal recidivism between juveniles with PTSD and juveniles without a mental illness.

August 2021

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People with mental disorders may be at increased risk of nutritional deficiencies due to poor diet. Poor diet is a major and modifiable cause of comorbid conditions, including metabolic syndrome and obesity. During pregnancy, it also contributes to the risk of developmental problems in the foetus.

What is the evidence for dietary patterns in people with PTSD?

Moderate quality evidence found there may be increased rates of poor dietary patterns in people with PTSD, although the evidence is very inconsistent.

August 2021

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Employment status is often indicative of the extent of one’s functional ability. Employment outcomes involve rates of employment and success in retaining employment, as well as patient characteristics, their environments, and interventions that influence employment rates.

What is the evidence for employment in people with PTSD?

Moderate to low quality evidence finds lower rates of returning to work in people with post-injury PTSD than in people without post-injury PTSD.

August 2021

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Forgiveness involves reducing negative thoughts, feelings, and behaviours toward a transgressor, as well as enhancing positive ones. It involves a willingness to abandon resentments, negative judgment, and indifferent behaviour, while fostering compassion, generosity, and love.

Studies have found evidence for both physical and psychological health benefits associated with forgiveness. This is because forgiving has the potential to break cycles of rumination and negative affect, which reduces stress and in turn improves various indicators of health. Long-term forgiveness habits (trait forgiveness) might better predict improved health outcomes than forgiving a specific offender or transgression (state forgiveness).

What is the evidence for forgiveness in people with PTSD?

Moderate to high quality evidence suggests increased levels of forgiveness is associated with decreased PTSD symptoms, although the effect may not be significant after adjusting for other trauma outcome variables such as depression, anxiety, anger, rumination, stress, and social functioning.

August 2021

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Functional outcomes refer to aspects of general life and day-to-day functioning. These may be impacted as a consequence of PTSD-related impairments, such as increased symptom severity. These in turn can impact adversely on treatment outcomes.

What is the evidence for functional outcomes in people with PTSD?

Moderate to high quality evidence finds PTSD symptoms were significantly associated with less social support and physical quality of life in cancer patients.

Moderate quality evidence suggests there may be poorer functioning in people with PTSD compared to people with anxiety disorders, particularly poor occupational functioning.

August 2021

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Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library.

August 2021

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Differences are observed in the age of onset of mental disorders, which may be influenced by genetic and/or environmental factors. While most individuals develop symptoms of PTSD within three months of the trauma, some symptoms can appear later and persist for months and sometimes years. Understanding the factors associated with the onset of symptoms could lead to better understanding of the disorder and earlier and improved intervention strategies for patients.

What is the evidence for illness onset of PTSD?

Moderate to high quality evidence finds the average age of onset of PTSD is 26.6 years, with no differences between males and females. The median age at onset is around 30 years.

The overall median prevalence of PTSD tends to reduce over time, from 28.8% at one-month post trauma to 17% at 12 months post trauma. Median prevalence post non-intentional (accidental) trauma also decreases over time (30.1% to 14%), while median prevalence post intentional (non-accidental) trauma is lower initially and increases over time (11.8% to 23.3%).

Around 24.5% of people diagnosed with PTSD had a delayed onset of illness, with most experiencing earlier milder symptoms. The prevalence of delayed-onset PTSD is highest in professional groups and those who experienced combat trauma.

August 2021

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The help-seeking efforts made by an individual and their families when symptoms of PTSD are apparent, and the clinical services made available as a result of these efforts, are collectively known as ‘pathways to care’. Pathways to care can also encompass service structures that have not been actively sought by the individual.

What is the evidence for pathways to care?

Moderate to low quality evidence found the most commonly reported facilitators to initiation of evidence-based interventions for PTSD were flexibility of manualised approaches, less fear of increasing client distress, less problems working with comorbidities, and more training and support for clinicians.

August 2021

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Increased physical activity has the potential to improve physical and mental health. Individuals with serious mental illnesses are more likely to be sedentary than the general population and are consequently at high risk for chronic medical conditions associated with inactivity. Positive psychological effects from physical activity in clinical populations have been reported, including improved quality of life.

What is the evidence for physical activity in people with PTSD?

Moderate quality evidence found lower levels of physical activity in people with PTSD compared to people without a mental illness. Lower levels of physical activity were associated with more severe symptoms, particularly hyperarousal symptoms. There were also more depression symptoms and poorer sleep quality in those with low physical activity levels.

August 2021

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Post-traumatic growth refers to positive psychological changes that occur after exposure to a traumatic event, and that are beyond previous levels of functioning. Growth can involve spiritual change, better relationships, more appreciation of life, new possibilities, and increased personal strength. This growth involves both the struggle and symptoms associated with trauma exposure and any positive outcomes that represent adaptation to the traumatic event.

What is the evidence for post-traumatic growth and PTSD symptoms?

Moderate to high quality evidence found a small to medium-sized association between increased severity of PTSD symptoms and increased post-traumatic growth. This association was strongest in children, in caregivers, and in people exposed to military conflicts, accidents, or natural disasters. The association was weakest in people exposed to diseases or those in helping professions, and was not present in people exposed to sexual abuse.

August 2021

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