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Posttraumatic stress disorder (PTSD) is a syndrome of stress reactions that can develop after either direct or indirect exposure to a traumatic event. These reactions are categorised within four symptom clusters: intrusive symptoms (nightmares and flashbacks), avoidance symptoms, negative changes in thoughts and mood, and heightened arousal. In addition, these symptoms must be present for at least one month and must cause psychological, social, or functional impairment.
The outcome of exposure to trauma is widely variable, and depends upon genetic factors, history of prior exposure, and psychical injuries sustained at the time of the trauma. The lifetime prevalence of PTSD varies between countries, but is seen in approximately 5-10% of the population. The 12 month prevalence of PTSD in the Australian population is approximately 5.2%.
Among serving ADF personnel, the 12 month prevalence of PTSD is 8.3%. The recent “Mental Health and Wellbeing Transition Study found that up to a half of transitioned ADF personnel have experienced a mental illness in the previous 12 months, and the lifetime prevalence of a mental illness is almost three quarters of transitioned ADF personnel. With this in mind, it is not surprising that, among transitioned ADF personnel, the 12 month prevalence of PTSD is 17.7% and the lifetime prevalence of PTSD is 24.9%.
The 12 month prevalence of 10% of PTSD among first responders worldwide, with no significant variation among region. Among this cohort, ambulance officers were significantly more likely to develop PTSD than firefighters, who were significantly more likely to develop PTSD than police officers exposed to a major disaster. The prevalence of PTSD among correctional workers is less studied, though the rate is likely to be similar to rates among first responders.
David Graham, BSc(Hons), MBBS, MPhil, PhD
Psychiatry Registrar | Concord Centre for Mental Health | NSW Health