Cited by 964Posttraumatic Stress Disorder ResearchChild Abuse and TraumaMigration, Health and Trauma

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Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

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Pietrzak, Robert H., Goldstein, Risë B., Southwick, Steven M., Grant, Bridget F.·2011·Journal of Anxiety Disorders

DOI 10.1016/j.janxdis.2010.11.010PMC PMC3051041

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Abstract

The present study used data from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (n = 34,653) to examine lifetime Axis I psychiatric comorbidity of posttraumatic stress disorder (PTSD) in a nationally representative sample of U.S. adults. Lifetime prevalences ± standard errors of PTSD and partial PTSD were 6.4% ± 0.18 and 6.6% ± 0.18, respectively. Rates of PTSD and partial PTSD were higher among women (8.6% ± 0.26 and 8.6% ± 0.26) than men (4.1% ± 0.19 and 4.5% ± 0.21). Respondents with both PTSD and partial PTSD most commonly reported unexpected death of someone close, serious illness or injury to someone close, and sexual assault as their worst stressful experiences. PTSD and partial PTSD were associated with elevated lifetime rates of mood, anxiety, and substance use disorders, and suicide attempts. Respondents with partial PTSD generally had intermediate odds of comorbid Axis I disorders and psychosocial impairment relative to trauma controls and full PTSD.

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BackgroundResultInfluential
A Pilot Study Evaluating a School-Based, Trauma-Focused Intervention for Immigrant and Refugee Youth
Mancini, M. A. (2019) · Child and Adolescent Social Work Journal · doi:10.1007/s10560-019-00641-8 · Cited by 36
Emotional avoidance and social support interact to predict depression symptom severity one year after traumatic exposure
Forbes, C. N., Tull, M. T., Xie, H., Christ, N. M., Brickman, K., Mattin, M., & Wang, X. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.112746 · Cited by 36
Screening for PTSD during pregnancy: a missed opportunity
Padin, A. C., Stevens, N. R., Che, M. L., Erondu, I., Perera, M. J., & Shalowitz, M. U. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04797-7 · Cited by 36
The Evolution of Post-Traumatic Stress Disorder following Moderate-to-Severe Traumatic Brain Injury
Alway, Y., Gould, K. R., McKay, A., Johnston, L., & Ponsford, J. L. (2015) · Journal of Neurotrauma · doi:10.1089/neu.2015.3992 · Cited by 32
Training in trauma psychology: A national survey of doctoral graduate programs.
Cook, J. M., Simiola, V., Ellis, A. E., & Thompson, R. (2017) · Training and Education in Professional Psychology · doi:10.1037/tep0000150 · Cited by 32
Evaluating treatments for posttraumatic stress disorder, alcohol and other drug use disorders using meta-analysis of individual patient data: Design and methodology of a virtual clinical trial
Saavedra, L. M., Morgan-López, A. A., Hien, D. A., López-Castro, T., Ruglass, L. M., Back, S. E., Fitzpatrick, S., Norman, S. B., Killeen, T. K., Ebrahimi, C. T., et al. (2021) · Contemporary Clinical Trials · doi:10.1016/j.cct.2021.106479 · Cited by 31
PTSD-related alcohol expectancies and impulsivity interact to predict alcohol use severity in a substance dependent sample with PTSD
Schaumberg, K., Vinci, C., Raiker, J. S., Mota, N. P., Jackson, M., Whalen, D. J., Schumacher, J. A., & Coffey, S. F. (2014) · Addictive Behaviors · doi:10.1016/j.addbeh.2014.09.022 · Cited by 31
Posttraumatic stress disorder and responses to couple conflict: Implications for cardiovascular risk.
Caska, C. M., Smith, T. W., Renshaw, K. D., Allen, S. N., Uchino, B. N., Birmingham, W. C., & Carlisle, M. (2014) · Health Psychology · doi:10.1037/hea0000133 · Cited by 31
PTSD, social anxiety disorder, and trauma: An examination of the influence of trauma type on comorbidity using a nationally representative sample
McMillan, K. A., & Asmundson, G. J. G. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.10.036 · Cited by 31
“Such theoretical formulations may be particularly relevant for sexual assault due to self-blame and stigmatization which frequently accompanies sexual victimization (Pietrzak et al., 2011).”
Background
Multimodal structural neuroimaging markers of risk and recovery from posttrauma anhedonia: A prospective investigation
Harnett, N. G., Stevens, J. S., Rooij, S. J. H., Ely, T. D., Michopoulos, V., Hudak, L., Jovanovic, T., Rothbaum, B. O., Ressler, K. J., & Fani, N. (2021) · Depression and Anxiety · doi:10.1002/da.23104 · Cited by 31
“These symptoms are orthogonal to the fear and hyperarousal aspects of PTSD (Armour, 2015; Breslau et al., 2005; Byrne et al., 2019; Pietrzak et al., 2011; Yang et al., 2017) and are reflective of deficits in reward‐related processes.”
Background
What changes when? The course of improvement during a stage-based treatment for suicidal and self-injuring women with borderline personality disorder and PTSD
Harned, M. S., Gallop, R. J., & Valenstein-Mah, H. R. (2018) · Psychotherapy Research · doi:10.1080/10503307.2016.1252865 · Cited by 30
Impulsivity interacts with momentary PTSD symptom worsening to predict alcohol use in male veterans
Black, A. C., Cooney, N. L., Sartor, C. E., Arias, A. J., & Rosen, M. I. (2018) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2018.1454935 · Cited by 31
PTSD symptom severity and impulsivity among firefighters: Associations with alcohol use
Bartlett, B. A., Smith, L. J., Lebeaut, A., Tran, J. K., & Vujanovic, A. A. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.06.039 · Cited by 30
Sexist Microaggressions: Traumatic Stressors Mediated by Self-Compassion
Cherry, M. A., & Wilcox, M. M. (2020) · The Counseling Psychologist · doi:10.1177/0011000020954534 · Cited by 30
“…of full and partial posttraumatic stress disorder (PTSD) is higher among women than men and that the differences cannot fully be explained by contextual factors, such as rates of sexual assault, prior depression or anxiety disorders, and sex-related symptom reporting biases (Pietrzak et al., 2011).”
Background
The prevalence of PTSS under the influence of public health emergencies in last two decades: A systematic review and meta-analysis
Zhou, Y., Sun, Z., Wang, Y., Xing, C., Sun, L., Shang, Z., & Liu, W. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101938 · Cited by 30
Classifying major mental disorders genetically
Cao, H., Wang, J., Baranova, A. V., & Zhang, F. (2021) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2021.110410 · Cited by 31
Pet Loss, Complicated Grief, and Post-Traumatic Stress Disorder in Hawaii
Adrian, J., & Stitt, A. L. (2017) · Anthrozoös · doi:10.1080/08927936.2017.1270598 · Cited by 30
The Hong Kong Survey on the Epidemiology of Trauma Exposure and Posttraumatic Stress Disorder
Wu, K. K., Leung, P. W. L., Wong, C. S. M., Yu, P. M. W., Luk, B. T. C., Cheng, J. P. K., Wong, R. M. F., Wong, P. P. S., Lui, J. C. C., Ngan, J. C. F., et al. (2019) · Journal of Traumatic Stress · doi:10.1002/jts.22430 · Cited by 29
Psychiatric Diagnoses and Treatment of U.S. Military Personnel While Deployed to Iraq
Schmitz, K. J., Schmied, E. A., Webb-Murphy, J. A., Hammer, P. S., Larson, G. E., Conway, T. L., Galarneau, M. R., Boucher, W. C., Edwards, N. K., & Johnson, D. C. (2012) · Military Medicine · doi:10.7205/milmed-d-11-00294 · Cited by 29
Development of a novel, integrated cognitive-behavioral therapy for co-occurring posttraumatic stress and substance use disorders: A pilot randomized clinical trial
Vujanovic, A. A., Smith, L. J., Green, C. E., Lane, S. D., & Schmitz, J. M. (2017) · Contemporary Clinical Trials · doi:10.1016/j.cct.2017.12.013 · Cited by 30
“, [3,47,48]] as well as the high rates of subclinical PTSD among SUD populations [e.”
Background
Time course of panic disorder and posttraumatic stress disorder onsets
Berenz, E. C., York, T. P., Bing‐Canar, H., Amstadter, A. B., Mezuk, B. R., Gardner, C. O., & Roberson‐Nay, R. (2018) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-018-1559-1 · Cited by 29
Veterans with PTSD report more weight loss barriers than Veterans with no mental health disorders
Klingaman, E. A., Hoerster, K. D., Aakre, J. M., Viverito, K. M., Medoff, D. R., & Goldberg, R. W. (2015) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2015.11.003 · Cited by 29
Pharmacological management of posttraumatic stress disorder
Bernardy, N. C., & Friedman, M. J. (2017) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2017.01.003 · Cited by 30
Chronic Pain and the Anxiety Disorders: Epidemiology, Mechanisms and Models of Comorbidity, and Treatment
Katz, J. D., Pagé, M. G., Fashler, S. R., Rosenbloom, B. N., & Asmundson, G. J. G. (2014) · Springer eBooks · doi:10.1007/978-2-8178-0414-9_8 · Cited by 29
“Subsyndromal (or partial) PTSD has been identifi ed by clinicians and researchers who have noted a substantial proportion of individuals report clinically signifi cant symptoms following exposure to a traumatic stressor, but they do not meet the full diagnostic criteria for PTSD [ 89 , 111 ].”
Background
The Impact of Co-occurring Post-traumatic Stress Disorder and Substance Use Disorders on Craving: A Systematic Review of the Literature
Renaud, F., Jakubiec, L., Swendsen, J. D., & Fatseas, M. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.786664 · Cited by 29
Does exposure exacerbate symptoms in veterans with PTSD and alcohol use disorder?
Tripp, J. C., Haller, M. M., Trim, R. S., Straus, E., Bryan, C. J., Davis, B. C., Lyons, R. C., Hamblen, J. L., & Norman, S. B. (2020) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000634 · Cited by 28
Posttraumatic Stress Disorder in Elite Athletes
Lynch, J. H. (2021) · Current Sports Medicine Reports · doi:10.1249/jsr.0000000000000918 · Cited by 30
Gender differences in disorders comorbid with posttraumatic stress disorder among U.S. Sailors and Marines
Walter, K. H., Levine, J. A., Madra, N. J., Beltran, J. L., Glassman, L. H., & Thomsen, C. J. (2022) · Journal of Traumatic Stress · doi:10.1002/jts.22807 · Cited by 33
The prevalence and clinical impairment of subthreshold PTSD using DSM‐5 criteria in a national sample of Korean firefighters
Kim, J. I., Oh, S., Park, H., Min, B., & Kim, J. (2020) · Depression and Anxiety · doi:10.1002/da.22998 · Cited by 28
Social Anxiety Disorder Is Associated With PTSD Symptom Presentation: An Exploratory Study Within A Nationally Representative Sample
McMillan, K. A., Sareen, J., & Asmundson, G. J. G. (2014) · Journal of Traumatic Stress · doi:10.1002/jts.21952 · Cited by 32
Associations between trauma and substance use among healthcare workers and public safety personnel during the SARS-CoV-2 (COVID-19) pandemic: the mediating roles of dissociation and emotion dysregulation
Patel, H., Easterbrook, B., D'Alessandro-Lowe, A. M., Andrews, K., Ritchie, K., Hosseiny, F., Rodrigues, S., Malain, A., O’Connor, C., Schielke, H., et al. (2023) · European Journal of Psychotraumatology · doi:10.1080/20008066.2023.2180706 · Cited by 27
“…literature indicating a high prevalence of comorbid PTSD+SUD in adult treatment-seeking samples (Chilcoat & Menard, 2004; Patel et al., 2021, 2022; Pietrzak et al., 2011), there is a crucial need to identify associations between PTSD and alcohol/substance-related problems among HCWs and PSP and…”
Background
Prospects for the Pharmacological Prevention of Post-Traumatic Stress in Vulnerable Individuals
Ostrowski, S. A., & Delahanty, D. L. (2014) · CNS Drugs · doi:10.1007/s40263-014-0145-7 · Cited by 28
Public attitudes and literacy about posttraumatic stress disorder in U.S. adults
Tsai, J., Shen, J., Southwick, S. M., Greenberg, S., Pluta, A., & Pietrzak, R. H. (2018) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2018.02.002 · Cited by 27
Self-citation
Study protocol for a non-inferiority randomised controlled trial of SKY breathing meditation versus cognitive processing therapy for PTSD among veterans
Mathersul, D. C., Tang, J. S., Schulz‐Heik, R. J., Avery, T. J., Seppala, E. M., & Bayley, P. J. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-027150 · Cited by 27
Psychosocial interventions for survivors of rape and sexual assault experienced during adulthood
Brown, S., Khasteganan, N., Brown, K., Hegarty, K. L., Carter, G. J., Tarzia, L., Feder, G. S., & O’Doherty, L. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013456 · Cited by 27
Intergenerational transmission of risk for PTSD symptoms in African American children: The roles of maternal and child emotion dysregulation.
Powers, A. D., Stevens, J. S., O’Banion, D., Stenson, A. F., Kaslow, N. J., Jovanović, T., & Bradley, B. (2020) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000543 · Cited by 30
“While approximately 70% of the United States population experiences at least one traumatic event in their lifetime (Breslau, 2009), only approximately 6% develop posttraumatic stress disorder (PTSD) (Pietrzak, Goldstein, Southwick, & Grant, 2011).”
Emotion Dysregulation Prospectively Predicts Posttraumatic Stress Disorder Symptom Severity 3 Months After Trauma Exposure
Forbes, C. N., Tull, M. T., RAPPORT, D. J., Xie, H., Kaminski, B., & Wang, X. (2020) · Journal of Traumatic Stress · doi:10.1002/jts.22551 · Cited by 28
Comorbid depressive symptoms in treatment-seeking PTSD outpatients affect multiple domains of quality of life.
Araújo, A. X., Berger, W., Coutinho, E., Marques-Portella, C., Luz, M. P., Cabizuca, M., Fiszman, A., Figueira, I., & Mendlowicz, M. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2013.09.004 · Cited by 36
“High current and lifetime comorbidity rates for major depressive disorders – around 60% – were found in individuals with PTSD in large clinical [55] and in nationally representative samples [56–58].”
Background
Treating Substance Abuse and Trauma Symptoms in Incarcerated Women
Swopes, R. M., Davis, J. L., & Scholl, J. A. (2015) · Journal of Interpersonal Violence · doi:10.1177/0886260515587668 · Cited by 30
At the Crossroads: The Intersection of Substance Use Disorders, Anxiety Disorders, and Posttraumatic Stress Disorder
Ruglass, L. M., López‐Castro, T., Cheref, S., Papini, S., & Hien, D. A. (2014) · Current Psychiatry Reports · doi:10.1007/s11920-014-0505-5 · Cited by 28
Treatment of Post-Traumatic Stress Disorders with the Alpha-1 Adrenergic Antagonist Prazosin
Simon, P. Y. R., & Rousseau, P. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659275 · Cited by 26
Augmenting the Treatment of PTSD with Ketamine—a Review
Duek, O. A., Kelmendi, B., Pietrzak, R. H., & Harpaz‐Rotem, I. (2019) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-019-00172-0 · Cited by 24
Self-citation
Bidirectional associations between alcohol use and intimate partner violence and sexual assault victimization among college women
Dardis, C. M., Ullman, S. E., Rodriguez, L. M., Waterman, E. A., Dworkin, E. R., & Edwards, K. M. (2021) · Addictive Behaviors · doi:10.1016/j.addbeh.2021.106833 · Cited by 26

Authors: Pietrzak, R. H., Goldstein, R. B., Southwick, S. M., & Grant, B. F.
Affiliations: Yale University (US)
National Institutes of Health (US)
Corresponding author: Pietrzak, Robert H.
ORCID: Pietrzak, Robert H.
Goldstein, Risë B.
Southwick, Steven M.
Venue: Journal of Anxiety Disorders
Publisher: Elsevier BV
Published: 2011-04
Volume: 25
Issue: 3
Pages: 456-465
ISSN: 0887-6185 (ISSN-L)
DOI: 10.1016/j.janxdis.2010.11.010
PMC: PMC3051041
OpenAlex: W1969551391
Cited by: 963
References: 87
Citations by year: 2026: 32 · 2025: 55 · 2024: 69 · 2023: 69 · 2022: 88 · 2021: 79 · 2020: 102 · 2019: 84 · 2018: 75 · 2017: 70 · 2016: 64 · 2015: 56 · 2014: 51 · 2013: 40 · 2012: 18
FWCI: 24.53
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Anxiety Disorders (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
National Institute on Drug Abuse (NIDA)
Intramural Program of the National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism
National Center for Posttraumatic Stress Disorder
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords: post-traumatic stress disorder, PTSD prevalence, psychiatric comorbidity, Axis I disorders, mood disorders, anxiety disorders, substance use disorders, suicide attempts, sex differences, trauma exposure, sexual assault, unexpected death, psychosocial impairment, NESARC
MeSH terms: Adult, Female, Health Surveys, Humans, Life Change Events, Male, Middle Aged, Psychiatric Status Rating Scales, Sex Factors, Stress Disorders, Post-Traumatic, United States, Comorbidity, Prevalence, Mood Disorders, Substance-Related Disorders

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Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions

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