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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“For instance, Stein et al. (1997) indicated that persons with full PTSD symptoms reported significantly more interference with work or school functioning than did persons with partial symptoms.”
BackgroundResultInfluential
Exploring Maternal and Child Effects of Comorbid Anxiety Disorders among African American Mothers with Depression
Boyd, R. C. (2013) · Journal of Depression & Anxiety · doi:10.4172/2167-1044.1000129 · Cited by 9
“Volume 2 • Issue 1 • 1000129 J Depress Anxiety ISSN: 2167-1044 JDA an open access journal Mixed symptoms & Syndromes of Anxiety & Depression Keywords: Comorbidity; Anxiety; Maternal Depression; Children; African Americans”
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“In addition, two epidemiological studies examined the risk of developing comorbidities with PTSD over a 12-month period (Sareen et al., 2007; Pietrzak et al., 2011).”
Background
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Raudales, A. M., Carosa, C. L., Weiss, N. H., Schatten, H. T., & Armey, M. F. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.03.002 · Cited by 7
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“Specifically, since the age at onset of PTSD is mainly suggested to be in the 20 s or 30 s [1, 2], further studies focusing on young adults are needed.”
Background
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Sanger, B., Alarachi, A., McNeely, H. E., McKinnon, M. C., & McCabe, R. E. (2025) · Psychology Research and Behavior Management · doi:10.2147/prbm.s461173 · Cited by 7
“Approximately 30% of those with PTSD report difficulties with alcohol use, and 25–50% report difficulties with substance use, 88,89 which may further increase risk of experiencing “brain fog” symptoms.”
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Wolf, E. J., & Miller, M. W. (2014) · Psychological Injury and Law · doi:10.1007/s12207-014-9193-z · Cited by 7
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“Partial PTSD has been associated Chung and Freh 7 Chung and Freh NP20979 with greater impairment in social functioning and physical and psychiatric comorbidity (e.g. Pietrzak et al., 2011).”
Background
Factors Associated with High-Risk Substance Use in Persons Receiving Psychiatric Treatment for a Primary Trauma- and Stressor-Related Disorder Diagnosis
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“This study hypothesized that 25– 50% of that treated sample would also have comorbid high-risk substance use, based on prior estimations (Pietrzak et al., 2011; Simpson et al., 2021).”
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State of the Science: Evidence‐based treatments for posttraumatic stress disorder delivered via telehealth
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Mancini, M. A., & Farina, A. S. J. (2019) · Journal of Ethnic & Cultural Diversity in Social Work · doi:10.1080/15313204.2019.1702132 · Cited by 8
“…is important to note that sub-syndromal or “partial” PTSD has been associated with prolonged impairment and higher lifetime prevalence rates of anxiety, depression, substance use disorders, suicide and personality disorders including borderline personality disorder (Pietrzak et al., 2011a, 2011b).”
Background
Written exposure therapy and app-delivered mindfulness-based meditation for PTSD and subthreshold PTSD in China: Design of a randomized controlled trial
Li, M., Wang, B., Chen, Q., Gao, D., & Zang, Y. (2021) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2021.100729 · Cited by 7
“4% [1], and continues to be a major global concern.”
Background
Dialectical Behavior Therapy for Early Life Trauma
Choi-Kain, L. W., Wilks, C. R., Ilagan, G. S., & Iliakis, E. A. (2021) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-021-00242-2 · Cited by 10
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Moderators for the Relationship between Post-Traumatic Stress Disorder and Opioid Use Disorder
Tasmim, S., Foll, B. L., & Hassan, A. N. (2022) · Journal of Dual Diagnosis · doi:10.1080/15504263.2021.2016341 · Cited by 8
“KEYWORDS PTSD; opioid use disorder; childhood adversities; moderators Among individuals with post-traumatic stress disorder (PTSD), 22.3% suffer from drug use disorders (Pietrzak et al., 2011; Shiner et al., 2017).”
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Mondi, C. F., Giovanelli, A., Ou, S., & Reynolds, A. J. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.02.008 · Cited by 7
Post-traumatic stress disorder prevalence and sleep quality in fire victims and rescue workers in southern Brazil: a cross-sectional study
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Roepke, S., Schoofs, N., Priebe, K., Wülfing, F., Schmahl, C. G., Röhle, R., Zähringer, J., Lotter, T., Otte, C., & Koglin, S. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04818-5 · Cited by 7
“More than 50% of patients with PTSD suffer from comorbid mood, anxiety, and substance-use disorders [16].”
Background
Co-Occurring Posttraumatic Stress Disorder Symptoms and Alcohol Use Behaviors: The Mediating Role of Drinking to Cope with PTSD Symptoms
Ferrie, M. L., Lheureux, A., Vujanovic, A. A., Zvolensky, M. J., & Raines, A. M. (2023) · Journal of Dual Diagnosis · doi:10.1080/15504263.2023.2260326 · Cited by 9
“Posttraumatic stress disorder (PTSD) and hazardous alcohol use often co-occur, with lifetime comorbidity estimates ranging from 24%-52% (Kessler et al., 1995; Mills et al., 2006; Pietrzak et al., 2011).”
Background
Differences between Latino individuals with posttraumatic stress disorder and those with other anxiety disorders.
Benítez, C. I. P., Sibrava, N. J., Zlotnick, C., Weisberg, R. B., & Keller, M. B. (2013) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/a0034328 · Cited by 8
Daily associations between PTSD, drinking, and self-appraised alcohol-related problems.
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Psychotherapie bei posttraumatischen Belastungsstörungen im Alter
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Transcriptomic analysis reveals moderate modulation of macrophage migration inhibitory factor superfamily genes in alcohol use disorders
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“The patients suffering from AUD and PTSD manifest greater severity of psychiatric pathologies and are more resistant to therapeutic interventions (4).”
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Efficacy and safety of acupuncture in treating post-traumatic stress disorder
Ding, N., Li, L., Song, K., Huang, A., & Zhang, H. (2020) · Medicine · doi:10.1097/md.0000000000020700 · Cited by 7
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The Efficacy of the Stellate Ganglion Block as a Treatment Modality for Posttraumatic Stress Disorder Among Active Duty Combat Veterans: A Pilot Program Evaluation.
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“The core symptoms of PTSD are intrusiveness of the traumatic event, avoidance of trauma-related stimuli, negative changes in cognition and emotion, and hypervigilance and overreaction.7 The 12-month prevalence of PTSD ranges from 0.2% to 3.8%, according to different social backgrounds and countries of residence.8 The…”
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Gielkens, E. M. J., Sobczak, S., Rossi, G. M. P., Rosowsky, E., & van Alphen, S. J. P. (2018) · Clinical Case Studies · doi:10.1177/1534650118790413 · Cited by 7
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Biscoe, N., Campbell, G. M., & Murphy, D. (2025) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2025.100520 · Cited by 6
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Melkonian, A. J., Flanagan, J. C., Calhoun, C. D., Hogan, J. N., & Back, S. E. (2021) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001434 · Cited by 6
“P osttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are highly prevalent and commonly co-occur.(1,2) Compared with the general population, military veterans are at increased risk for both PTSD and AUD and suffer poorer treatment engagement and outcomes compared with individuals with standalone”
Background
PROTOCOL: Group‐based interventions for posttraumatic stress disorder: A systematic review and meta‐analysis of the role of trauma type
Griffin, S. M., Lebedová, A., Ahern, E., McMahon, G., Bradshaw, D., & Muldoon, O. T. (2023) · Campbell Systematic Reviews · doi:10.1002/cl2.1328 · Cited by 8
“People who experience PTSD often experience co‐morbid psychiatric conditions (Pietrzak et al., 2011), report a lower quality of life and poorer functional outcomes (Magruder et al., 2004; Schnurr et al., 2006; Zatzick et al., 2002), and are at increased risk for suicide (Guerra & Calhoun, 2011;…”
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Impact of three variants of prolonged exposure therapy on comorbid diagnoses in patients with childhood abuse-related PTSD
Hoeboer, C. M., Kullberg, M. J., Oprel, D. A. C., Schoorl, M., van Minnen, A., Antypa, N., Mouthaan, J., de Kleine, R. A., & van der Does, W. A. J. (2024) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2024.2318729 · Cited by 6
“Comorbidity rates of substance use disorders in PTSD are high (up to 49%; Breslau et al., 2003; Kessler et al., 1995; Pietrzak et al., 2011; Walter et al., 2018).”
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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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