Disasters and PTSD


How are disasters related to risk of PTSD?

Exposure to at least one trauma is required for a diagnosis of PTSD. The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) determines direct traumas as threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Indirect traumas include witnessing the trauma, or learning that a relative or close friend was exposed to a trauma. Differences in trauma characteristics, including the severity and type of exposure, can affect the risk of developing PTSD. Personal characteristics such as age and sex also influence risk.

What is the evidence for PTSD in people exposed to disasters?

Moderate quality evidence found a large increase in PTSD symptoms in people exposed to natural disasters compared to those not exposed. There were small to medium-sized associations between exposure to disasters and increased PTSD symptoms in youth (≤18 years). The association was strongest in females, in children exposed to disasters with a higher death toll, in those in close proximity to the disaster, and in those with increased perceived threat and distress. There was a medium-sized increase in PTSD symptoms in older adults (60-65 years) than younger adults following exposure to natural disasters. However, there was also a medium-sized decrease in PTSD symptoms in older adults than younger adults following exposure to man-made disasters. Review authors suggest this may be explained by older adults having less likelihood of evacuating during a natural disaster, while previous experiences may better prepare older people to cope with human-induced disasters.

The incidence rate of PTSD after a flood is around 16%. Incidence rates after a flood were highest within six months and in people who experienced severe flood intensity. The incidence rate of PTSD after an earthquake is around 24%. Incidence rates after an earthquake were highest within nine months, in females, and in people who had damage to their houses. Being older, trapped, experiencing fear, injury, bereavement, and witnessing injury/death during the earthquake were all related to greater risk of PTSD. Having a higher education was associated with more PTSD in children but less PTSD in adults following an earthquake.

August 2021

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Last updated at: 1:11 am, 12th October 2021
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