Traumatic events are very common in most societies, though prevalence has been best studied in industrialized societies, particularly in the United States. Kessler et al. (1995) found that in the United States at least 15 percent of the population reports having been molested, physically attacked, raped, or been involved in combat. Each year, about 3 million children in the United States are reported for neglect and/or abuse to child protective services, with more than half of these cases later substantiated. The vast majority of the abuse and neglect found in children occurs at the hands of their primary caregivers and people they know: Four out of five assaults on children are at the hands of their own parents. For women and children, but not for men, trauma that results from violence within intimate relationships is a much more serious problem than traumatic events inflicted by strangers or accidents. Half of all victims of violence in the United States are under age 25; 29 percent of all forcible rapes occur before the age of 11. Among U.S. adolescents aged 12 to 17, 8 percent are estimated to have been victims of serious sexual assault; 17 percent are victims of serious physical assault; and 40 percent have witnessed serious violence (Kilpatrick et al., 1998). Over a third of the victims of domestic assault experienced serious injury, compared with a quarter of victims of stranger assault (van der Kolk, 2000).

Posttraumatic stress disorder now is a common diagnosis for patients in psychiatric hospitals. An examination of the records of the 384,000 Medicaid recipients in Massachusetts in 1997/98 (Macy et al., 2002) revealed that PTSD had the same prevalence as depression—generally considered the most common psychiatric diagnoses. However, patients with PTSD spent 10 times more days in the hospital than patients with the diagnosis of depression only. There is no evidence that the 22,800 Medicaid recipients in Massachusetts who were diagnosed as suffering from PTSD suffered only from a one-time traumatic incident, such as a rape or motor vehicle accident. Most suffer from a complex constellation of symptoms that include those of PTSD. However, currently the long-term psychiatric impact of chronic, multiple traumas receives the same diagnosis (PTSD) as do the effects of a one-time incident. The inevitable multiplicity of problems seen after chronic and repeated exposure are currently described oversimply as seemingly random "comorbid" conditions. PTSD, as a diagnosis, commonly fails to capture how convoluted the clinical presentation of many traumatized individuals is and how complex their treatment can be.

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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