War and terrorism

What is prevalence?

For a person to be diagnosed with PTSD, exposure to at least one trauma is required. Traumas as determined by the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) include threatened death, actual or threatened serious injury, and actual or threatened sexual violence. Trauma characteristics, along with personal characteristics, influence the risk of developing PTSD.

What is the evidence for the risk of PTSD in people exposed to war and terrorism?

Moderate to high quality evidence finds a large effect of more post-traumatic stress symptoms in World War 2 holocaust survivors than in people with no holocaust background. The effect was largest in people who were children when exposed. There was also a small effect of increased PTSD in children exposed to the Israeli-Palestinian conflict compared to children not exposed.

The prevalence of PTSD in war-affected refugees and citizens is around 31%. Rates were highest in samples exposed to recent conflict, to torture, to more potentially traumatic events, to political terror, and in people from Cambodia, Bosnia, Kosovo, and Africa. The risk factors associated with increased risk of PTSD in military personnel and veterans exposed to combat were (in descending order of effect) discharging a weapon, witnessing someone being wounded or killed, experiencing severe trauma, having deployment-related stressors, being in the army rather than other military branches, having direct combat exposure, being a non-officer, having previous adverse life events, being combat specialists, being female, having prior psychological problems, low education, longer and more deployments, being non-White, and having previous prior trauma. There were protective effects of having high unit cohesion and post-deployment support in military personnel and veterans.

There was a medium-sized effect of increased PTSD in people directly rather than indirectly exposed to the New York World Trade Centre attack. Risk was highest in civilians and in people who were injured during the attack.

August 2021

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Last updated at: 12:49 am, 6th August 2021
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