Trauma and PTSD

Trauma is one of the most intuitively understandable, and simultaneously one of the most misunderstood, conditions in the DSM. Modeled through analogy to physical trauma, trauma refers to the psychologically destabilizing effect that a powerful and disturbing event can cause. As with physical trauma, psychological trauma is often experienced as a sudden jolt to the system. Originally identified by soldiers arriving home from World War I who returned easily frightened, had difficulty focusing, and had a constant feeling of being “on edge,” despite not having any of these traits prior to the war. The label for that condition has changed several times, frequently with explicit reference to wars where it was most often observed. However, in recognition of the fact that extreme events can occur outside of war, it is now labeled post-traumatic stress disorder or PTSD

Trauma and PTSD

Trauma overwhelms the minds normal processing and interrupts the normal way sensory information is stored. This is why memories of traumatic events are often fragmented or fixed on a particular object or sound or feeling. That is, in our normal lives, we integrate, visual, auditory, tactile, olfactory, proprioceptive, etc. inputs into a coherent sense of self and the world without thinking. Traumatic experiences interrupt that integration causing the event to feel permanent and the person to feel stuck in that moment.

Traumas feel terrible and when they remain unprocessed and unintegrated, can progress into PTSD. PTSD is a far more severe and persistent condition characterized, in part, by disproportionate emotional responses to events, self-destructive behavior, and extreme difficulty with sleep and concentration. PTSD can be truly debilitating, interfering with work, preventing relationships from forming, and causing extreme stress responses.

How Common is it?

Data from the National Comorbidity Survey Replication revealed that in 2001-2003 roughly 4% of all adults and 5% of all adolescents met symptom criteria for post-traumatic stress disorder each year.[1] The percentage number can be misleading: that is about 13 million people in the United States have PTSD in any given year.

As with depression and anxiety, rates of PTSD are higher among adolescents and young adults. As of 2018, rates of PTSD in college students was roughly similar to the national average (again, around 4%), but it jumped to 7.5% between  2021-2022. [2] This jump is particularly worrisome as even subclinical levels of post-traumatic stress (PTSS) can interfere with functioning across almost all measures (e.g., academic, social, emotional, etc). [3]

Women have higher rates of trauma as well. Lifetime prevalences are around 6% for men and 8% for women.[4] As women are unfortunately the target of sexual, physical, and emotional abuse, the higher prevalence of trauma in women is perhaps not surprising. Pregnancy, giving birth, and motherhood also contribute to the increase. According to one prominent study, 45% of new mothers reported birth trauma[5] which can in turn re-traumatize women who are survivors of sexual abuse.[6]

Trauma Therapy and PTSD Treatment in NYC

Therapy for trauma and therapy for PTSD are remarkably effective. A large number of systematic and meta-analytic reviews attest to the efficacy of psychotherapy for PTSD [7]and, crucially, that treatment has long-term effects.[8] This seems to hold true for particularly affected groups as well. One recent meta-analysis found that trauma-focused therapies for new mothers “are consistently found to be effective for ameliorating PTSD symptoms” as well as “reducing PTSD symptom severity” [9] and that Trauma focused cognitive behavioral therapy (or, TF-CBT) is effective among children and adolescents (Morina). In fact, research suggests that therapy for trauma is more effective than pharmacological treatments.[10]

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[1] National Institute of Mental Health. (n.d.) Post-traumatic Stress Disorder. Retrieved from: https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd#part_2612)

[2] Zhai, Y., Du, X. (2024). Trends in Diagnosed Posttraumatic Stress Disorder and Acute Stress Disorder in U.S. College Students, 2017-2022. Jama Network Open, 7(5): e2413874

[3] Lai, B. S., La Greca, A. M., Auslander, B. A., & Short, M. B. (2013). Children’s symptoms of posttraumatic stress and depression after a natural disaster: Comorbidity and risk factors. Journal of Affective Disorders, 146(1), 71–78. https:// doi.org/10.1016/j.jad.2012.08.041

[4] U.S. Dept. of Veterans Affairs. (2025). PTSD: National Center for PTSD. Retrieved from: https://www.ptsd.va.gov/understand/common/common_adults.asp

[5] Alcorn, K. L., O’Donovan, A., Patrick, J. C., Creedy, D., & Devilly, G. J. (2010). A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events. Psychological Medicine, 40(11), 1849–1859.

[6] LoGiudice, J. A. (2016). A systematic literature review of the childbearing cycle as experienced by survivors of sexual abuse. Nursing for Women’s Health, 20(6), 582–594.

[7] Bradley, R., Green, J., Russ, E., Dutra, L., Westen, D. (2005) A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162, 214-227.

Cusack, K., Jones, D.E., Forneris, C.A., Wines, C., Sonis, J., Middleton, J.C., ... Gaynes, B. N. (2016). Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis. Clinical Psychology Review, 43, 128-141.

Lee, D. J., Schnitzlein, C. W., Wolf, J. P., Vythilingam, M., Rasmusson, A. M., Hoge, C.W. (2016). Psychotherapy versus pharmacotherapy for posttraumatic stress disorder: Systemic review and meta-analyses to determine first-line treatments

Depression and Anxiety, 33, 792-806.

Powers, M. B., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., Foa, E. B. (2010).

A meta-analytic review of prolonged exposure for posttraumatic stress disorder

Clinical Psychology Review, 30, 635-641.

Watts, B. V., Schnurr, P. P., Mayo, L., Young-Xu, Y., Weeks, W. B., Friedman, M. J. (2013). Meta-analysis of the efficacy of treatments for post-traumatic stress disorder

Journal of Clinical Psychiatry, 74, 541-550.

[8] Kline, A. C., Cooper, A. A., Rytwinski, N.K., Feeny, N. C. (2018). Long-term efficacy of psychotherapy for posttraumatic stress disorder: a meta-analysis of randomized controlled trials. Clinical Psychology Review, 59, 30-40.

[9] Furuta, M., Horsch, A., Ng, E. S. W., Bick, D., Spain, D., Sin, J. (2018). Effectiveness of Trauma-Focused Psychological Therapies for Treating Post-traumatic Stress Disorder Symptoms in Women Following Childbirth: A Systematic Review and Meta-Analysis. Frontiers in Psychiatry, 9.)

[10] Merz J, Schwarzer G, Gerger H. (2019) Comparative Efficacy and Acceptability of Pharmacological, Psychotherapeutic, and Combination Treatments in Adults With Posttraumatic Stress Disorder: A Network Meta-analysis. JAMA Psychiatry, 76(9), 904–913.