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Rashin damuwa bayan rauni

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Rashin damuwa bayan rauni
Description (en) Fassara
Iri stress-related disorders (en) Fassara
sequelae (en) Fassara
Field of study (en) Fassara psychiatry (en) Fassara
clinical psychology (en) Fassara
Sanadi yaƙi, Cin zarafin jiki, sexual violence (en) Fassara, psychological abuse (en) Fassara, 'Yan gudun hijira, Yaƙi, Raunin kwakwalwa
Babban rauni
Symptoms and signs (en) Fassara mummunan mafarki, anxiety, Rashin bacci, flashback (en) Fassara
Tunanin da ba a yarda da shi ba
Physical examination (en) Fassara Davidson Trauma Scale (en) Fassara, Structured Clinical Interview for DSM-IV (en) Fassara
psychological evaluation (en) Fassara
Genetic association (en) Fassara KAT2B (en) Fassara, DPP6 (en) Fassara, TRMT9B (en) Fassara, ADCY8 (en) Fassara, TLL1 (en) Fassara, NDRG1 (en) Fassara, GABBR2 (en) Fassara, AKT3 (en) Fassara, SLC4A5 (en) Fassara, FAM49B (en) Fassara, ZMAT3 (en) Fassara, PRKCA (en) Fassara da PRKN (en) Fassara
Therapy (en) Fassara
Magani sertraline (en) Fassara, paroxetine (en) Fassara, fluoxetine (en) Fassara, prazosin (en) Fassara, venlafaxine (en) Fassara, prolonged exposure therapy (en) Fassara, eye movement desensitization and reprocessing (en) Fassara, cognitive behavioral therapy (en) Fassara, cognitive processing therapy (en) Fassara, trauma focused cognitive behavioral therapy (en) Fassara, selective serotonin reuptake inhibitor (en) Fassara, Serotonin-Norepinephrine Reuptake Inhibitors (en) Fassara da tricyclic antidepressant (en) Fassara
Identifier (en) Fassara
ICD-10-CM F43.10, F43.11, F43.12 da F43.1
ICD-9-CM 309.81
ICD-10 F43.1
ICD-9 309.81
DiseasesDB 33846
MedlinePlus 000925
eMedicine 000925
MeSH D013313
Disease Ontology ID DOID:2055

Matsalar damuwa bayan tashin hankali ( PTSD ) [lower-alpha 1] cuta ce ta kwakwalwa da ke tasowa daga fuskantar wani mummunan lamari, kamar cin zarafin jima'i, tashin hankalin gida, cin zarafin yara, yaƙi da raunin da ke tattare da shi, bala'in halitta, baƙin ciki, haɗarin zirga-zirga, ko wasu barazanar da ke kan rayuwar mutum ko walwalarsa. [1] [2] [3] Alamomin na iya haɗawa da tunani mai tayar da hankali, ji, ko mafarki da suka shafi abubuwan da suka faru, damuwa ta hankali ko ta jiki ga alamun da suka shafi rauni, yunƙurin guje wa alamun da suka shafi rauni, canje-canje a yadda mutum yake tunani da ji, da kuma ƙaruwar martanin faɗa ko gudu . [1] [4] Waɗannan alamun suna ɗaukar fiye da wata guda bayan abin da ya faru kuma suna iya haɗawa da abubuwan da ke haifar da rashin hankali . [1] Yara ƙanana ba sa nuna damuwa, amma maimakon haka suna iya bayyana tunaninsu ta hanyar wasa . [5] [1]

Yawancin mutanen da suka fuskanci mummunan yanayi ba sa kamuwa da cutar PTSD. [6] Mutanen da ke fuskantar tashin hankali tsakanin mutane kamar fyaɗe, wasu hare-haren jima'i, sace mutane, bibiya, cin zarafin jiki daga abokin tarayya na kud da kud, da cin zarafin yara sun fi kamuwa da cutar PTSD fiye da waɗanda ke fuskantar mummunan yanayi ba tare da kai hari ba, kamar haɗurra da bala'o'i na halitta . [7] [8] [9] A Amurka, kusan kashi 3.5% na manya suna da cutar PTSD a cikin shekara guda, kuma kashi 9% na mutane suna kamuwa da ita a wani lokaci a rayuwarsu. [1] A mafi yawan sauran sassan duniya, yawan mace-mace a cikin shekara guda yana tsakanin 0.5% zuwa 1%. [1] Yawan mace-mace na iya faruwa a yankunan da ake fama da rikici . [6] Ya fi yawa a cikin mata fiye da maza. [10]

Wani bita da nazari mai zurfi da aka yi kwanan nan ya nuna cewa yawan kamuwa da cutar PTSD ta ICD-11 da PTSD mai rikitarwa sun kai kashi 2% da 4%, bi da bi, a tsakanin manya a ƙasashe/yankuna/yankuna da ba a yaƙi ba/wadanda suka ci gaba da tattalin arziki; sun karu zuwa kashi 6% da 15%, bi da bi, a ƙasashe/yankuna da yaƙi ya shafa/wadanda ba su da ci gaba da tattalin arziki. [11]

Rigakafi na iya yiwuwa idan aka yi amfani da shawara ga waɗanda ke da alamun farko, amma ba ya tasiri idan aka ba wa duk mutanen da suka fuskanci rauni ko da kuwa alamun suna nan. [6] Manyan magungunan da ake amfani da su ga mutanen da ke fama da PTSD su ne ba da shawara (psychotherapy) da magani. [4] [12] Yawancin magungunan haɗin gwiwa (psychotherapy da pharmacotherapy) ba su yi kama da sun fi tasiri fiye da psychotherapy kaɗai ba, [6] [13] sai dai wataƙila ta hanyar MDMA . [14] Fa'idodin magani sun yi ƙasa da waɗanda ake gani tare da ba da shawara. [6] Magungunan hana damuwa na nau'in SSRI ko SNRI sune magunguna na farko da ake amfani da su don PTSD kuma suna da amfani ga kusan rabin mutane. [15] Magunguna, banda wasu SSRIs ko SNRIs, ba su da isassun shaida don tallafawa amfani da su kuma, a yanayin benzodiazepines, na iya ƙara ta'azzara sakamako. [16] [17]

An rubuta alamun cututtukan kwakwalwa da suka shafi rauni tun aƙalla zamanin tsoffin Helenawa . An yi jayayya cewa akwai wasu misalai na shaidar rashin lafiya bayan rauni tun ƙarni na sha bakwai da sha takwas, kamar littafin Samuel Pepys, wanda ya bayyana alamun shiga tsakani da damuwa bayan Gobarar Landan ta 1666. A lokacin yaƙe-yaƙen duniya, an san wannan yanayin a ƙarƙashin kalmomi daban-daban, ciki har da " shock shell ", "neurons na yaƙi", neurasthenia da ' combat neurosis '. [18] Kalmar "post-traumatic stress disorder" ta fara amfani da ita a shekarun 1970, galibi saboda gano tsoffin sojojin Amurka na Yaƙin Vietnam . Ƙungiyar Masu tabin hankali ta Amurka ta amince da ita a hukumance a shekarar 1980 a bugu na uku na Littafin Bincike da Ƙididdiga na Cututtukan Hankali (DSM-III). [19] tare da karuwar tarin wallafe-wallafen asibiti kan tsoffin sojojin Yaƙin Vietnam. [20]

Alamomi da Alamomi

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Ma'aikatan hidima suna amfani da fasaha don rage alamun PTSD .

Alamomin PTSD galibi suna farawa ne a cikin watanni uku na farko bayan abin da ya faru na tayar da hankali, amma ba za su fara ba sai bayan shekaru da yawa. [4] A cikin yanayin da aka saba, mutumin da ke da PTSD yana ci gaba da guje wa tunani da motsin rai da suka shafi rauni ko tattaunawa game da abin da ya faru na rauni kuma yana iya samun rashin bacci na abin da ya faru ( rashin bacci na dissociative ). [1] Duk da haka, mutumin yakan sake tunawa da abin ta hanyar tunawa da abin da ya faru, maimaituwa, abubuwan da suka faru na rabuwar kai na sake rayuwa da raunin (" tunani "), da mafarkai masu ban tsoro (50 zuwa 70%). [21] [22] Duk da cewa abu ne da aka saba samun alamun bayan wani abin da ya faru na rauni, dole ne waɗannan su ci gaba da isasshe (watau, haifar da rashin aiki a rayuwa ko matakan damuwa na asibiti) na tsawon fiye da wata ɗaya bayan raunin da za a rarraba shi a matsayin PTSD (rashin aiki mai mahimmanci a asibiti ko damuwa na ƙasa da wata ɗaya bayan raunin na iya zama matsalar damuwa mai tsanani ). [1] [23] Wasu bayan wani mummunan lamari suna fuskantar ci gaba bayan mummunan yanayi . [24] Mu'amalar zamantakewa tsakanin mutanen da ke fuskantar mummunan yanayi na iya yin tasiri ga alamun PTSD ɗinsu, gami da sukar abokan hulɗa da ke sa wanda abin ya shafa ya ji laifi. [25] [ buƙatun sabuntawa ]

Yanayin lafiya masu alaƙa

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Wadanda suka tsira daga rauni sau da yawa suna fuskantar damuwa, rashin jin daɗi, da kuma rashin jin daɗi a yanayi baya ga PTSD. [26] Fiye da kashi 50% na waɗanda ke fama da PTSD suna da damuwa, yanayi, ko kuma matsalolin shan ƙwayoyi .

Matsalolin amfani da miyagun ƙwayoyi, kamar matsalar shan giya, galibi suna faruwa tare da PTSD. Farfadowa daga matsalar damuwa bayan rauni ko wasu matsalolin damuwa na iya zama cikas, ko kuma ta ƙara ta'azzara, lokacin da matsalolin amfani da miyagun ƙwayoyi suka zama kamar PTSD. Magance waɗannan matsalolin na iya kawo ci gaba a yanayin lafiyar kwakwalwa da matakan damuwa na mutum. [27] [28]

PTSD yana da alaƙa mai ƙarfi da tinnitus, [29] kuma akwai hasashe cewa PTSD na iya haifar da wasu tinnitus da aka gani tare da wannan yanayin. [30]

Ana kuma danganta PTSD da wasu cututtuka da dama da suka shafi lafiyar jiki waɗanda suka haɗa da kumburi da rashin daidaita tsarin garkuwar jiki. [31]

A cikin yara da matasa, akwai alaƙa mai ƙarfi tsakanin wahalhalun daidaita motsin rai (misali, canjin yanayi, tashin hankali, fushi ) da alamun damuwa bayan tashin hankali, ba tare da la'akari da shekaru, jinsi, ko nau'in raunin ba. [32]

Raunin ɗabi'a, jin damuwa ta ɗabi'a, kamar kunya ko laifi bayan aikata laifi na ɗabi'a, yana da alaƙa da PTSD amma an bambanta shi da shi. Raunin ɗabi'a yana da alaƙa da kunya da laifi, yayin da PTSD yana da alaƙa da damuwa da tsoro. [33] : 2, 8, 11 

Abubuwan Haɗari

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Mutanen da ake ganin suna cikin haɗarin kamuwa da cutar PTSD sun haɗa da ma'aikatan yaƙi, waɗanda suka tsira daga bala'o'i na halitta, waɗanda suka tsira daga sansanin tsare-tsare, da waɗanda suka tsira daga aikata laifuka masu tsanani. Mutanen da ake aiki a wuraren da ke fallasa su ga tashin hankali (kamar sojoji) ko bala'o'i (kamar ma'aikatan agajin gaggawa ) suma suna cikin haɗari. [34] Sauran ayyukan da ke cikin haɗarin sun haɗa da jami'an 'yan sanda, masu kashe gobara, masu ba da agajin gaggawa, ma'aikatan motar asibiti, ƙwararrun kula da lafiya, direbobin jirgin ƙasa, masu nutsewa, 'yan jarida, da ma'aikatan jirgin ruwa, da kuma mutanen da ke aiki a bankuna, ofisoshin gidan waya, ko shaguna. [35] Ƙarfin abin da ya faru na raunin yana da alaƙa da haɗarin kamuwa da cutar PTSD, tare da gogewa da ta shafi mutuwa da aka gani, ko shaida ko fuskantar azabtarwa, rauni, lalacewar jiki, raunin kwakwalwa mai rauni wanda ke da alaƙa sosai da haɓakar cutar PTSD. Hakazalika, abubuwan da ba a zata ba ko kuma waɗanda wanda abin ya shafa ba zai iya tserewa ba suma suna da alaƙa da babban haɗarin kamuwa da cutar PTSD. [36]

Rauni

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An danganta PTSD da nau'ikan abubuwan da suka faru na rauni iri-iri. Hadarin kamuwa da PTSD bayan wani mummunan lamari ya bambanta dangane da nau'in rauni [37] kuma shine mafi girman abin da ya biyo bayan azabtarwa (40%) [38] da cin zarafin jima'i (11.4%), musamman fyade (19.0%). [39] Maza sun fi fuskantar wani mummunan lamari (kowane iri), amma mata sun fi fuskantar irin wannan mummunan lamari mai tasiri wanda zai iya haifar da PTSD, kamar cin zarafin mutane da cin zarafin jima'i .

Wadanda suka tsira daga hatsarin mota, yara da manya, suna cikin haɗarin kamuwa da cutar PTSD. [40] [41] A duk duniya, kusan kashi 2.6% na manya ana gano su da cutar PTSD bayan hatsarin mota wanda ba shi da barazana ga rayuwa, kuma irin wannan adadin yara yana kamuwa da cutar PTSD. [39] Haɗarin kamuwa da cutar PTSD kusan ya ninka zuwa kashi 4.6% saboda haɗarin mota mai barazana ga rayuwa. [39] Mata sun fi fuskantar yiwuwar kamuwa da cutar PTSD bayan hatsarin mota, ko da kuwa hatsarin ya faru ne a lokacin ƙuruciya ko kuma lokacin girma. [40] [41]

An yi nazari kan martanin damuwa bayan tashin hankali a cikin yara da matasa. [42] Adadin PTSD na iya zama ƙasa a cikin yara fiye da manya, amma idan babu magani, alamun na iya ci gaba tsawon shekaru da yawa. Wani kimantawa ya nuna cewa adadin yara da matasa da ke fama da PTSD a cikin al'umma mara tabbas a cikin ƙasa mai ci gaba na iya zama 1% idan aka kwatanta da 1.5% zuwa 3% na manya. [43] A matsakaici, 16% na yaran da suka fuskanci wani mummunan lamari suna kamuwa da PTSD, tare da faruwar ya bambanta dangane da nau'in fallasa da jinsi. [44] Kamar yadda yake ga manya, abubuwan da ke haifar da PTSD a cikin yara sun haɗa da: jinsi na mata, fallasa ga bala'o'i, halayen jurewa marasa dacewa, [45] ko rashin tsarin tallafin zamantakewa mai kyau. [46]

Samfuran masu hasashen sun ci gaba da gano cewa raunin da yara ke fuskanta, wahalar da ke addabarsu, bambance-bambancen jijiyoyi, da matsalolin iyali suna da alaƙa da haɗarin kamuwa da PTSD bayan wani mummunan lamari a lokacin girma. [47] [48] [49] Ya kasance da wuya a sami ɓangarorin hasashen abubuwan da ke faruwa akai-akai waɗanda ke hasashen, amma rabuwar peritraumatious ya kasance alamar hasashen ci gaban PTSD. [50] Kusanci, tsawon lokaci, da tsananin raunin yana yin tasiri. An yi hasashe cewa raunin da ke tsakanin mutane yana haifar da matsaloli fiye da na waɗanda ba na mutane ba, amma wannan abin jayayya ne. [51] Hadarin kamuwa da PTSD yana ƙaruwa a cikin mutanen da ke fuskantar cin zarafi ta jiki, cin zarafi ta jiki, ko sace mutane . [52] [53] Matan da ke fuskantar cin zarafi ta jiki sun fi kamuwa da PTSD fiye da maza. [52]

Abokin Hulɗa da Cin Zarafin Jima'i

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Mutumin da aka yi wa cin zarafin gida yana da haɗarin kamuwa da cutar PTSD. Akwai alaƙa mai ƙarfi tsakanin ci gaban cutar PTSD a cikin uwaye waɗanda suka fuskanci cin zarafin gida a lokacin da suke da juna biyu . [54]

Waɗanda suka fuskanci cin zarafi ta hanyar jima'i ko fyaɗe na iya samun alamun cutar PTSD. [55] Yiwuwar samun alamun PTSD mai ɗorewa ya fi girma idan mai fyaden ya tsare ko ya danne mutumin, idan wanda aka yi wa fyaden ya yi imanin cewa mai fyaden zai kashe shi, mutumin da aka yi wa fyaden ƙarami ne ko babba, kuma idan mai fyaden wani ne da suka sani. Yiwuwar ci gaba da samun alamun cutar ma ya fi girma idan mutanen da ke kusa da wanda ya tsira sun yi watsi da (ko ba su san) fyaɗen ba ko kuma sun zargi wanda ya tsira daga fyaɗen. [56]

Rauni da ya shafi yaƙi, 'yan gudun hijira

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Sojojin suna fuskantar mummunan yanayi a lokacin yaƙi. Bayan an tura su zuwa yankin yaƙi, ana samun damar fuskantar yanayi mai barazana ga rayuwa. Sauran abubuwan da suka faru na iya zama rauni ko mutuwa, haɗarin haɗari ko kuma gawarwakin mutane da aka yi musu magani.

Aikin soja a fagen fama abu ne mai haɗarin kamuwa da cutar PTSD. [36] Kimanin kashi 22% na mutanen da suka fuskanci yaƙi suna kamuwa da cutar PTSD; a cikin kusan kashi 25% na ma'aikatan soja waɗanda suka kamu da cutar PTSD, bayyanarsa tana jinkiri. [36]

'Yan gudun hijira kuma suna cikin haɗarin kamuwa da cutar PTSD saboda yadda suke fuskantar yaƙi, wahalhalu, da kuma abubuwan da suka faru masu ban tausayi. Adadin masu fama da cutar PTSD a cikin 'yan gudun hijira ya kama daga kashi 4% zuwa 86%. [57] Duk da cewa damuwar yaƙi tana shafar duk wanda abin ya shafa, mutanen da aka kora sun fi sauran mutane. [58]

Kalubalen da suka shafi lafiyar 'yan gudun hijira gabaɗaya suna da sarkakiya kuma an yi su ne da bambanci daban-daban. 'Yan gudun hijira sun sami raguwar jin daɗin rayuwa da kuma yawan damuwa ta hankali saboda rauni da ya faru a baya da kuma wanda ke ci gaba da faruwa. Ƙungiyoyin da abin ya shafa musamman kuma waɗanda galibi ba a biya musu buƙatunsu ba su ne mata, tsofaffi, da yara ƙanana marasa rakiya. Damuwa da baƙin ciki bayan tashin hankali a cikin al'ummar 'yan gudun hijira suma suna shafar nasarar karatunsu. [59]

Mutuwar da ba a zata ba ta ƙaunataccen mutum

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Mutuwar kwatsam ta ƙaunatacce ita ce nau'in mummunan lamari da aka fi ruwaitowa a cikin binciken ƙasa da ƙasa. [39] [60] Duk da haka, yawancin mutanen da suka fuskanci irin wannan lamari ba za su kamu da PTSD ba. Wani bincike daga Hukumar Lafiyar Hankali ta Duniya ta WHO ya gano cewa akwai haɗarin kamuwa da PTSD da kashi 5.2% bayan sun ji labarin mutuwar ƙaunatacce ba zato ba tsammani. [60] Saboda yawan wannan mummunan lamari, mutuwar ƙaunatacce ba zato ba tsammani ta kai kusan kashi 20% na waɗanda suka kamu da PTSD a duk duniya. [39]

Rashin lafiya mai barazana ga rayuwa ko tsanani

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Cututtukan lafiya da ke da alaƙa da ƙaruwar haɗarin kamuwa da cutar PTSD sun haɗa da ciwon daji, [61] [62] [63] bugun zuciya, [64] da bugun jini. [65] Kashi 22% na waɗanda suka tsira daga cutar kansa suna da alamun PTSD na tsawon rai. [66] Asibiti a sashin kulawa mai tsanani (ICU) shi ma yana haifar da haɗarin kamuwa da cutar PTSD. [67] Wasu mata suna fuskantar PTSD daga abubuwan da suka fuskanta dangane da cutar kansar nono da tiyatar cire mastectomy . [68] [69] [61] Waɗanda aka ƙaunace su daga waɗanda suka fuskanci cututtuka masu barazana ga rayuwa suma suna cikin haɗarin kamuwa da cutar PTSD, kamar iyayen yaro mai cututtuka na yau da kullun. [70]

Yanayin bakan tabin hankali

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Akwai bincike da ke nuna cewa waɗanda suka tsira daga cututtukan tabin hankali, waɗanda ke wanzuwa a cikin cututtuka kamar schizophrenia, schizoaffective disorder, bipolar I disorder, da sauransu, suna cikin haɗarin kamuwa da PTSD. Wannan galibi yana faruwa ne saboda abubuwan da mutum zai iya fuskanta a lokacin da kuma bayan tabin hankali. Irin waɗannan abubuwan da suka faru sun haɗa da, amma ba'a iyakance ga su ba, abubuwan da suka faru a asibitocin tabin hankali, hulɗar 'yan sanda, ƙyamar zamantakewa, da kunya saboda halayen tabin hankali, halayen kashe kai da yunƙurin, ruɗu da abubuwan da ba su dace ba, da kuma tsoron rasa iko ko ainihin rashin iko. Yawan kamuwa da PTSD a cikin waɗanda suka tsira daga tabin hankali na iya zama ƙasa da kashi 11% kuma sama da kashi 67%. [71] [72] [73]

Ciwon daji

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Kiyasin yawan kamuwa da cutar PTSD da ke da alaƙa da ciwon daji ya kama tsakanin 7% zuwa 14%, [74] tare da ƙarin 10% zuwa 20% na marasa lafiya da ke fuskantar alamun damuwa bayan rauni (PTSS). [75] [76] An danganta PTSD da PTSD da PTSD da ƙaruwar damuwa da rashin ingancin rayuwa, [77] kuma an ruwaito su a cikin sabbin marasa lafiya da aka gano da kuma waɗanda suka tsira daga cutar na dogon lokaci. [78]

Gwaje-gwajen filin PTSD don Littafin Bincike da Kididdiga, Bugu na Huɗu ( DSM-IV ), ya bayyana cewa kashi 22% na waɗanda suka tsira daga cutar kansa suna da PTSD (CR-PTSD) da ke da alaƙa da cutar kansa a tsawon rayuwarsu, suna amincewa da ganewar cutar kansa da kuma magani a matsayin abin damuwa mai raɗaɗi. [79]

Saboda haka, yayin da adadin mutanen da aka gano suna da cutar kansa ke ƙaruwa kuma waɗanda suka tsira daga cutar kansa ke ƙaruwa, PTSD da ke da alaƙa da cutar kansa ya zama babban batu, don haka samar da buƙatun jiki da na tunani ga marasa lafiya da cutar kansa yana ƙara zama mahimmanci. [80]

Raunin da ya shafi ciki

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Matan da suka yi rashin ciki suna cikin haɗarin kamuwa da cutar PTSD. [81] [82] [83] Waɗanda suka yi rashin ciki a baya suna da haɗarin kamuwa da cutar PTSD idan aka kwatanta da waɗanda suka yi fama da cutar guda ɗaya kawai. [81] Hakanan PTSD na iya faruwa bayan haihuwa kuma haɗarin yana ƙaruwa idan mace ta sami rauni kafin daukar ciki. [84] [85] An kiyasta cewa yawan PTSD bayan haihuwa na yau da kullun (wato, ban da haihuwar da ba ta mutu ba ko manyan matsaloli) yana tsakanin 2.8 zuwa 5.6% a makonni shida bayan haihuwa, [86] tare da raguwar adadin zuwa 1.5% a watanni shida bayan haihuwa. [86] [87] Alamomin PTSD suna da yawa bayan haihuwa, tare da yawan kamuwa da cutar 24-30.1% [86] a makonni shida, suna raguwa zuwa 13.6% a watanni shida. [88] Haihuwa ta gaggawa kuma tana da alaƙa da PTSD.

Bala'o'in yanayi

[gyara sashe | gyara masomin]

Mutanen da suka fuskanci bala'o'i na halitta kamar ambaliyar ruwa, girgizar ƙasa, tsunami, guguwa, da gobara na iya haifar da matsalar damuwa bayan tashin hankali. [89] Wani bincike da aka yi a kan nazarin da aka yi kan PTSD bayan bala'o'i tsakanin 1980 da 2007 ya gano cewa yawan PTSD bayan bala'o'i na halitta ya yi ƙasa da yawan da ke faruwa bayan bala'o'in da ɗan adam ya aikata. Wannan bita ya gano cewa yawan PTSD yana shafar kusan mutum ɗaya cikin huɗu da suka tsira daga girgizar ƙasa (23.66%). [90] Abubuwan da ke tantance haɗarin kamuwa da PTSD bayan bala'i sun haɗa da girman raunin jiki, haɗarin rayuwa, da adadin mace-mace. [91] An nuna kusancin yanki zuwa cibiyar bala'i na halitta yana ba da gudummawa ga mutanen da ke kamuwa da PTSD. [92] Bala'o'i na iya raba iyalai da kuma ƙalubalantar jin daɗin iko da tsaro na mutane. [93] Farfaɗowar lafiyar kwakwalwa ta mutane, al'ummomi da ƙasashe bayan gaggawa, gami da bala'o'i na halitta, yana da mahimmanci don dalilai na zamantakewa da tattalin arziki. Shirye-shiryen gaggawa da amsawar lafiyar kwakwalwa suna buƙatar yin tasiri bayan bala'o'i na halitta. [94]

Halittar Halitta

[gyara sashe | gyara masomin]

Akwai shaida cewa kamuwa da cutar PTSD gado ne . Kimanin kashi 30% na bambancin da ke cikin PTSD yana faruwa ne ta hanyar kwayoyin halitta kawai. [50] Ga tagwaye da aka fallasa ga yaƙi a Vietnam, samun tagwaye monozygotic (irin ɗaya) tare da PTSD yana da alaƙa da ƙaruwar haɗarin kamuwa da cutar tagwaye da PTSD idan aka kwatanta da tagwaye dizygotic (tagwaye marasa iri ɗaya). [95] Mata masu ƙaramin hippocampus na iya samun yuwuwar kamuwa da PTSD bayan wani mummunan lamari bisa ga binciken farko. [96] Bincike ya kuma gano cewa PTSD yana da tasirin kwayoyin halitta da yawa waɗanda suka saba da sauran cututtukan tabin hankali. Tsoro da rikice-rikicen damuwa gabaɗaya, kuma PTSD yana da kashi 60% na bambancin kwayoyin halitta iri ɗaya. Barasa, nicotine, da dogaro da miyagun ƙwayoyi suna da kamanceceniya sama da kashi 40%. [50] Masanin kimiyyar jijiyoyi Dr. Rachel Yehuda ta yi bincike kan yadda raunin tunani zai iya tafiya a cikin tsararraki, musamman mai da hankali kan raunin da ya faru tsakanin tsararraki tare da waɗanda suka tsira daga Holocaust da 'ya'yansu. Masu binciken a cikin bincikenta sun mayar da hankali kan kwayar halittar damuwa mai suna FKBP5 wacce ke da alaƙa da PTSD. Sakamakon wannan binciken ya nuna abubuwan da ke cikin kwayoyin halittar PTSD yayin da suka nuna tasirin methylation na kwayar halittar FKBP5 a cikin iyayen da suka fuskanci rauni a sansanonin tattarawa, da kuma 'ya'yansu. [97]

Ra'ayoyin Juyin Halitta

[gyara sashe | gyara masomin]

Ra'ayoyin Ilimin Halayyar Juyin Halitta da Ilimin Halayyar Juyin Halitta suna fassara alamun PTSD a matsayin nau'ikan martanin kariya masu tsauri ko marasa tsari waɗanda suka kasance masu amfani a cikin mahallin kakanninmu. [98] Kulawa sosai, tunawa da abubuwan da ke kutsewa, da kuma martanin firgita da aka yi fiye da kima na iya nuna yawan kunna hanyoyin da aka tsara don haɓaka rayuwa bayan rauni. [99] Duk da cewa waɗannan labaran na iya taimakawa wajen daidaita ƙungiyoyin alamun, sake dubawa sun jaddada cewa suna ci gaba da kasancewa a ka'ida kuma suna buƙatar haɗin kai da binciken neurobiological da psychosocial.

Ilimin Halittar Jiki

[gyara sashe | gyara masomin]

Ilimin Jijiyoyin Jiki (Neuroendocrinology)

[gyara sashe | gyara masomin]

Alamomin PTSD na iya faruwa lokacin da wani abin da ya faru na rauni ya haifar da amsawar adrenaline mai yawa, wanda ke haifar da zurfin tsarin jijiyoyi a cikin kwakwalwa. Waɗannan alamu na iya daɗe bayan abin da ya haifar da tsoro, yana sa mutum ya zama mai saurin amsawa ga yanayi na tsoro na gaba. A lokacin abubuwan da suka faru na rauni, yawan matakan hormones na damuwa da ke fitowa suna hana ayyukan hypothalamic wanda zai iya zama babban abin da ke haifar da ci gaban PTSD. [100]

PTSD yana haifar da canje-canje a cikin ƙwayoyin halitta a cikin kwakwalwa da jiki wanda ya bambanta da sauran cututtukan tabin hankali, kamar babban baƙin ciki . Mutanen da aka gano suna da PTSD suna mayar da martani sosai ga gwajin rage dexamethasone fiye da mutanen da aka gano suna da baƙin ciki na asibiti . [101] [102]

Yawancin mutanen da ke fama da PTSD suna nuna ƙarancin sinadarin cortisol da kuma yawan sinadarin catecholamines a cikin fitsari, [103] tare da rabon norepinephrine /cortisol wanda hakan ya fi na mutanen da ba a gano cutar ba. [104] Wannan ya bambanta da martanin yaƙi ko tashi na yau da kullun, inda matakan catecholamine da cortisol ke ƙaruwa bayan an fallasa su ga wani abu mai damuwa. [105]

Matakan catecholamine na kwakwalwa suna da yawa, [106] kuma yawan corticotropin-releasing factor (CRF) yana da yawa. [107] Tare, waɗannan binciken suna nuna rashin daidaituwa a cikin axis na hypothalamic-pituitary-adrenal (HPA) .

An nuna cewa kiyaye tsoro ya haɗa da axis na HPA, tsarin locus coeruleus - noradrenergic, da kuma alaƙar da ke tsakanin tsarin limbic da frontal cortex . Axis na HPA wanda ke daidaita martanin hormone ga damuwa, [108] wanda ke kunna tsarin LC-noradrenergic, yana da alaƙa da yawan haɗakar tunanin da ke faruwa bayan rauni. [109] Wannan yawan haɗuwa yana ƙara yiwuwar kamuwa da cutar PTSD. Amygdala tana da alhakin gano barazanar da kuma martanin tsoro da ba a cika sharaɗi ba waɗanda ake aiwatarwa a matsayin martani ga barazana. [50]

Tsarin HPA yana da alhakin daidaita martanin hormone ga damuwa. [50] Ganin ƙarfin hana cortisol ga dexamethasone a cikin PTSD, rashin daidaituwar axis na HPA wataƙila ya dogara ne akan ƙarfin hana martani mara kyau na cortisol, saboda ƙaruwar amsawar glucocorticoid masu karɓa . [110]

An yi hasashen cewa PTSD hanya ce ta koyo da ba ta dace ba don jin tsoron amsawa ta hanyar tsarin HPA mai saurin amsawa, mai saurin amsawa, da kuma mai saurin amsawa. [111]

Ƙananan matakan cortisol na iya haifar da PTSD ga mutane: Bayan raunin yaƙi, sojojin Sweden da ke aiki a Bosnia da Herzegovina waɗanda ke da ƙarancin matakan cortisol na yau da kullun kafin aikin soja suna da haɗarin kamuwa da alamun PTSD, bayan raunin yaƙi, fiye da sojoji waɗanda ke da matakan da suka dace kafin aikin soja. [112] Saboda cortisol yawanci yana da mahimmanci wajen dawo da yanayin jiki bayan amsawar damuwa, ana tsammanin waɗanda suka tsira daga raunin da suka samu tare da ƙarancin cortisol suna fuskantar rashin isasshen amsawa - wato, tsawon lokaci da damuwa - wanda ke kafa matakin PTSD.

Ana tsammanin cewa tsarin locus coeruleus-noradrenergic yana daidaita yawan haɗuwar ƙwaƙwalwar tsoro. Matakan cortisol masu yawa suna rage ayyukan noradrenergic, kuma saboda mutanen da ke da PTSD suna da ƙarancin matakan cortisol, an ba da shawarar cewa mutanen da ke da PTSD ba za su iya daidaita karuwar amsawar noradrenergic ga damuwa mai rauni ba. [100] Ana tsammanin tunanin abubuwan da ke shiga jiki da martanin tsoro na yanayi sakamakon martanin abubuwan da ke haifar da hakan. An ruwaito cewa Neuropeptide Y (NPY) yana rage sakin norepinephrine kuma an nuna yana da kaddarorin anxiolytic a cikin samfuran dabbobi. Nazarin ya nuna cewa mutanen da ke da PTSD suna nuna raguwar matakan NPY, wataƙila yana nuna ƙaruwar matakan damuwa. [50]

Wasu bincike sun nuna cewa mutanen da ke fama da PTSD suna da ƙarancin sinadarin serotonin akai-akai, wanda ke ba da gudummawa ga alamun halayyar da ake yawan haɗuwa da su kamar damuwa, jita-jita, fushi, tashin hankali, kisan kai, da kuma rashin himma. [113] Serotonin kuma yana ba da gudummawa ga daidaita samar da glucocorticoid.

Yawan amsawa a cikin tsarin norepinephrine kuma yana iya faruwa ne ta hanyar ci gaba da fuskantar matsananciyar damuwa. Yawan kunnawar masu karɓar norepinephrine a cikin prefrontal cortex na iya haɗawa da tunawa da mafarki da mafarkai marasa daɗi da waɗanda ke fama da PTSD ke fuskanta akai-akai. Rage wasu ayyukan norepinephrine (sanin yanayin da ake ciki) yana hana hanyoyin tunawa a cikin kwakwalwa sarrafa abin da ya faru, kuma motsin zuciyar da mutum ke fuskanta yayin tunawa ba shi da alaƙa da yanayin da ake ciki yanzu. [113]

Akwai cece-kuce mai yawa a cikin al'ummar likitoci game da ilimin halittar kwakwalwa na PTSD. Wani bita na 2012 ya nuna babu wata alaƙa bayyananna tsakanin matakan cortisol da PTSD. Yawancin rahotanni sun nuna cewa mutanen da ke da PTSD suna da matakan hormone mai sakin corticotropin, ƙananan matakan cortisol na basal, da kuma ƙara yawan martanin da ba daidai ba na tsarin HPA ta hanyar dexamethasone . [50] [114]

Ilimin Jijiyoyin Jiki

[gyara sashe | gyara masomin]

Nazarin da aka yi kan garkuwar jiki ta gefe ya gano cewa rashin aiki tare da matakan cytokine masu yawa da kuma haɗarin kamuwa da cututtukan da ke da alaƙa da garkuwar jiki a tsakanin mutanen da ke da PTSD. [115] An kuma gano matsalar garkuwar jiki a cikin PTSD, wanda ke ƙara yiwuwar dakatar da amsawar garkuwar jiki ta tsakiya saboda raguwar ayyukan ƙwayoyin cuta a cikin kwakwalwa sakamakon ƙalubalen garkuwar jiki. Mutanen da ke da PTSD, idan aka kwatanta da masu sarrafawa, suna da ƙarancin ƙaruwa a cikin alamar kunna ƙwayoyin cuta ( 18-kDa translocator protein ) bayan shan lipopolysaccharide . [116] Wannan hana garkuwar jiki yana da alaƙa da tsananin alamun anhedonic. Masu bincike sun ba da shawarar cewa jiyya da nufin dawo da aikin garkuwar jiki na iya zama da amfani don rage alamun PTSD. [116]

Ilimin jijiyoyi

[gyara sashe | gyara masomin]
Yankunan kwakwalwa da ke da alaƙa da damuwa da kuma matsalar damuwa bayan rauni [117]

Wani bincike mai zurfi na nazarin MRI na tsarin jiki ya gano alaƙa da raguwar jimlar girman kwakwalwa, girman intracranial, da girman hippocampus, insula cortex, da kuma anterior cingulate . [118] Yawancin wannan binciken ya samo asali ne daga PTSD a cikin waɗanda suka fuskanci Yaƙin Vietnam. [119]

Mutane masu fama da PTSD suna da raguwar aikin kwakwalwa a cikin dorsal da rostral anterior cingulate cortices da kuma ventromedial prefrontal cortex, wuraren da ke da alaƙa da gogewa da daidaita motsin rai. [120]

Amygdala tana da hannu sosai wajen ƙirƙirar tunanin motsin rai, musamman tunanin da ke da alaƙa da tsoro. A lokacin damuwa mai yawa, ana danne hippocampus, wanda ke da alaƙa da sanya tunanin a cikin mahallin sarari da lokaci da kuma tunawa da ƙwaƙwalwa,. A cewar wata ka'ida, wannan dannewa na iya zama sanadin tunawa da zai iya shafar mutanen da ke fama da PTSD. Lokacin da wani da ke fama da PTSD ya fuskanci abubuwan da suka faru kamar abin da ya faru da rauni, jiki yana ganin abin da ya faru a matsayin abin da ya sake faruwa saboda ba a taɓa rubuta tunanin da kyau a cikin ƙwaƙwalwar mutumin ba. [50] [121]

Duk da cewa gabaɗaya, ana ba da rahoton yawan aiki amygdala ta hanyar nazarin meta na aikin neuroimaging a cikin PTSD, akwai babban bambanci, fiye da a cikin matsalar damuwa ta zamantakewa ko rashin lafiyar phobic. Idan aka kwatanta dorsal (kusan CeA) da ventral (kusan BLA), yawan aiki ya fi ƙarfi a cikin ventral cluster, yayin da yawan aiki ya bayyana a cikin dorsal cluster. Bambancin na iya bayyana motsin rai mara kyau a cikin PTSD (ta hanyar rage hankali a cikin CeA) da kuma ɓangaren da ke da alaƙa da tsoro.

Ganewar Ganewa

[gyara sashe | gyara masomin]

NICE ta ba da shawarar likitoci su fahimci nau'ikan alamomin da ke da alaƙa da nakasa a aiki da kuma abubuwan da suka faru waɗanda aka san suna taimakawa wajen haɓaka cutar PTSD. Ana ba da shawarar yin takamaiman tambayoyi yayin tantancewa da kuma la'akari da yawan abubuwan da suka faru na rauni da aka fuskanta. Ya kamata kimantawa ta kasance cikakke, gami da kimanta buƙatun jiki, tunani, da zamantakewa da kuma kimanta haɗari. [122]

Yin ganewar asali na PTSD na iya zama da wahala saboda:

  • yanayin da yawancin sharuɗɗan ganewar asali ke ciki (kodayake wannan gaskiya ne ga yawancin matsalolin kwakwalwa);
  • yiwuwar yin rahoto fiye da kima, misali, yayin neman fa'idodin nakasa, ko kuma lokacin da PTSD zai iya zama abin da ke rage yawan yanke hukunci a kan laifuka [123]
  • yiwuwar rashin bayar da rahoto, misali, ƙyama, alfahari, tsoro cewa ganewar cutar PTSD na iya hana wasu damar aiki;
  • alamun sun haɗu da wasu matsalolin tunani kamar su rashin ƙarfi da damuwa ta gaba ɗaya;
  • alaƙa da wasu matsalolin tunani kamar babban rashin kwanciyar hankali da kuma rashin jin daɗin rayuwa gabaɗaya;
  • matsalolin amfani da miyagun ƙwayoyi, waɗanda galibi ke haifar da wasu alamu da alamu iri ɗaya kamar PTSD; da
  • Matsalolin amfani da miyagun ƙwayoyi na iya ƙara haɗarin kamuwa da cutar PTSD ko kuma ƙara ta'azzara alamun PTSD ko duka biyun; da kuma
  • PTSD yana ƙara haɗarin kamuwa da matsalolin amfani da miyagun ƙwayoyi. [124]
  • Bambancin bayyanar alamun a al'adance (musamman dangane da gujewa da alamomin da ke rage radadi, mafarkai masu ban tausayi, da alamomin damuwa)

Rigakafi

[gyara sashe | gyara masomin]

An ga ƙananan fa'idodi tun daga farkon samun damar yin amfani da maganin halayyar fahimta . An ba da shawarar kula da damuwa mai mahimmanci a cikin abubuwan da suka faru a matsayin hanyar hana PTSD, amma binciken da aka yi daga baya ya nuna cewa yana iya haifar da sakamako mara kyau. [125] [126] ] Wani bita na Cochrane na 2019 bai sami shaidar da ke tallafawa amfani da shiga tsakani ba kuma cewa "shiga tsakani da yawa na iya haifar da mummunan sakamako fiye da rashin shiga tsakani, ga wasu mutane." [127] Hukumar Lafiya ta Duniya ta ba da shawarar hana amfani da benzodiazepines da magungunan rage damuwa don damuwa mai tsanani (alamomin da ke ɗaukar ƙasa da wata ɗaya). Wasu shaidu suna goyon bayan amfani da hydrocortisone don rigakafi ga manya, kodayake akwai iyaka ko babu shaidar da ke tallafawa propranolol, escitalopram, temazepam, ko gabapentin . [128] [129]

Bayanin ilimin halayyar ɗan adam

[gyara sashe | gyara masomin]

Mutane da suka fuskanci rauni sau da yawa suna karɓar magani da ake kira bayanin tunani don hana PTSD, wanda ya ƙunshi tambayoyi da aka yi niyya don ba wa mutane damar fuskantar lamarin kai tsaye da kuma raba ra'ayoyinsu ga mai ba da shawara da kuma taimakawa wajen tsara tunaninsu game da abin da ya faru. [130] Duk da haka, wasu nazarin meta-bincike sun gano cewa bayanin tunani ba shi da amfani, yana iya zama mai illa kuma baya rage haɗarin kamuwa da PTSD a nan gaba. [36] [131] [132] Wannan gaskiya ne ga bayanin zaman zama ɗaya da kuma tsoma baki da yawa na zaman. [127] Kamar yadda yake a shekarar 2017 , Ƙungiyar Ilimin Halayyar Dan Adam ta Amurka ta tantance bayanin tunani a matsayin Babu Tallafin Bincike/Magani da Zai Iya Cutarwa . [133]

Shige da fice da wuri

[gyara sashe | gyara masomin]

An gano cewa maganin da aka mayar da hankali kan rauni da aka bayar cikin kwanaki ko makonni na abin da zai iya haifar da rauni yana rage alamun PTSD. [134] Kamar yadda aka yi bayani kan yanayin tunani, manufar shiga tsakani da wuri ita ce rage yawan alamun damuwa, don hana sake farawa ko sake dawowa da matsalolin kwakwalwa da kuma ƙarin damuwa daga baya a cikin tsarin warkarwa. [135]

Tsare-tsare masu niyya ga haɗari

[gyara sashe | gyara masomin]

Tsare-tsare masu nufin haɗari su ne waɗanda ke ƙoƙarin rage takamaiman bayanai ko abubuwan da suka faru. Yana iya yin niyya ga kwaikwayon halaye na yau da kullun, koyarwa kan aiki, ko bayar da bayanai kan abin da ya faru. [136] [137]

Gudanarwa

[gyara sashe | gyara masomin]

Hadin maganin

[gyara sashe | gyara masomin]

Yawancin maganin haɗin gwiwa (maganin tunani da na magunguna) ba su da alama sun fi tasiri fiye da maganin tunani kawai, [6] [13] sai dai yiwuwar maganin psychotherapy wanda MDMA ta taimaka . [14] Sharhi goma sha huɗu na masu halartar har zuwa 353 sun nuna cewa maganin psychotherapy wanda MDMA ta taimaka na iya inganta alamun PTSD, amsawa, da ƙimar sassauci sosai idan aka kwatanta da maganin psychotherapy kaɗai, amma shaidar tana da ƙarancin tabbaci zuwa ƙarancin tabbaci kuma bayanan aminci suna da iyaka, tare da ƙaruwar wasu abubuwan da ba su dace ba na ɗan lokaci. [14]

Kanada tana tsara iyakataccen rarraba MDMA bayan an nemi izini daga Health Canada kuma an amince da ita. [138] A Ostiraliya, likitocin tabin hankali na musamman da aka ba da izini na iya rubuta shi a cikin maganin PTSD. [139] Duk da cewa a da ta ɗauki MDMA a matsayin " maganin nasara ", FDA ta ƙi amincewa da shi saboda maganin PTSD a cikin 2024, tana ambaton ƙirar gwaji da damuwa game da aminci.

A cewar wasu sharhi, taimakon MDMA ta hanyar psychotherapy yana rage alamun PTSD idan aka kwatanta da magungunan sarrafawa kuma yana nuna yanayin aminci mai jurewa gabaɗaya; ana rage amfani da shi ta hanyar ƙananan girma na samfura da tasirin da ba su dace ba . [140] [141] Ana iya ƙididdige yiwuwar tasirin magani na MDMA saboda rashin rufe ido da kuma son zuciya na masu halarta. [142] [143] [144]

Wasu hanyoyin, musamman waɗanda suka shafi tallafin zamantakewa, [145] [146] suma suna da mahimmanci. Wani gwaji a fili na ilimin halayyar ɗan adam ya ba da rahoton yawan sassauci daga alamun PTSD ba tare da amfani da fallasa ba. [147]

Magani

[gyara sashe | gyara masomin]

An nuna cewa magunguna guda huɗu masu rage damuwa (sertraline, fluoxetine, paroxetine, da venlafaxine) suna da ƙaramin amfani fiye da placebo. [17]

Maganin damuwa

[gyara sashe | gyara masomin]

Magungunan da ke hana sake amfani da serotonin (SSRIs) da kuma masu hana sake amfani da serotonin-norepinephrine (SNRIs) na iya samun wasu fa'idodi ga alamun PTSD. [17] [148] [149] Magungunan hana daukar ciki na tricyclic suna da tasiri iri ɗaya, amma ba a jure su sosai ba. [150] Shaida tana ba da goyon baya ga ƙaramin ci gaba ko matsakaici tare da sertraline, fluoxetine, paroxetine, da venlafaxine . [17] [151] Don haka, ana ɗaukar waɗannan magunguna guda huɗu a matsayin magunguna na farko ga PTSD. [148] [15] Hukumar Abinci da Magunguna ta Amurka (FDA) ta amince da paroxetine da sertraline na SSRI don maganin PTSD . [36]

Benzodiazepines

[gyara sashe | gyara masomin]

Benzodiazepines batu ne da ake jayayya a kai game da maganin PTSD saboda wasu shaidu da ke nuna haɗarin ƙara tsanantar alamun PTSD. [152] Wasu marubuta sun yi imanin cewa amfani da benzodiazepines ba a yarda da shi ba don damuwa mai tsanani, domin wannan rukunin magunguna na iya haifar da rabuwar kai . [153] Duk da haka, wasu suna amfani da benzodiazepines da taka tsantsan don damuwa na ɗan gajeren lokaci da rashin barci. [154] Duk da cewa benzodiazepines na iya rage damuwa mai tsanani, babu wata shaida da ta tabbatar da cewa suna iya dakatar da ci gaban PTSD kuma a zahiri suna iya ƙara haɗarin kamuwa da PTSD sau 2-5. [16] Wasu sun ce bai kamata a yi amfani da benzodiazepines nan da nan bayan wani mummunan lamari ba domin suna iya ƙara alamun da ke da alaƙa da PTSD. [36]

Benzodiazepines na iya rage tasirin hanyoyin magance matsalar tabin hankali, kuma akwai wasu shaidu da ke nuna cewa benzodiazepines na iya taimakawa wajen ci gaba da kuma tsawon lokacin PTSD. Ga waɗanda suka riga sun kamu da cutar PTSD, benzodiazepines na iya ta'azzara kuma su tsawaita lokacin rashin lafiya, ta hanyar ƙara ta'azzara sakamakon ilimin halayyar ɗan adam, da kuma haifar da ko ƙara ta'azzara tashin hankali, baƙin ciki (gami da kashe kai), da kuma amfani da miyagun ƙwayoyi. [16] Kurakurai sun haɗa da haɗarin kamuwa da dogaro da benzodiazepine, haƙuri (watau, fa'idodin ɗan gajeren lokaci suna ƙarewa da lokaci), da kuma ciwon janyewa ; bugu da ƙari, mutanen da ke fama da cutar PTSD (har ma waɗanda ba su da tarihin shan barasa ko shan ƙwayoyi ba) suna cikin haɗarin cin zarafin benzodiazepines . [15] [155]

Manazarta

[gyara sashe | gyara masomin]
  1. ↑ Acceptable variants of this term exist; see the Terminology section in this article.
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  1. 1 2 3 4 5 6 7 8 Empty citation (help)
  2. ↑ "Post-traumatic stress disorder (PTSD) – Symptoms and causes". Mayo Clinic. Retrieved 2019-10-08.
  3. ↑ Wild, Jennifer; Duffy, Michael; Ehlers, Anke (2023). "Moving forward with the loss of a loved one: treating PTSD following traumatic bereavement with cognitive therapy". Cognitive Behaviour Therapist. 16. doi:10.1017/S1754470X23000041. ISSN 1754-470X. PMC 10160000 Check |pmc= value (help). PMID 37159811 Check |pmid= value (help).
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  8. ↑ Kessler RC, Aguilar-Gaxiola S, Alonso J, Benjet C, Bromet EJ, Cardoso G, Degenhardt L, de Girolamo G, Dinolova RV, Ferry F, Florescu S, Gureje O, Haro JM, Huang Y, Karam EG, Kawakami N, Lee S, Lepine JP, Levinson D, Navarro-Mateu F, Pennell BE, Piazza M, Posada-Villa J, Scott KM, Stein DJ, Ten Have M, Torres Y, Viana MC, Petukhova MV, Sampson NA, Zaslavsky AM, Koenen KC (2017-10-27). "Trauma and PTSD in the WHO World Mental Health Surveys". European Journal of Psychotraumatology. 8 (sup5). doi:10.1080/20008198.2017.1353383. PMC 5632781. PMID 29075426. As detailed in another recent WMH report, conditional risk of PTSD after trauma exposure is 4.0%, but varies significantly by trauma type. The highest conditional risk is associated with being raped (19.0%), physical abuse by a romantic partner (11.7%), being kidnapped (11.0%), and being sexually assaulted other than rape (10.5%). In terms of broader categories, the traumas associated with the highest PTSD risk are those involving intimate partner or sexual violence (11.4%), and other traumas (9.2%), with aggregate conditional risk much lower in the other broad trauma categories (2.0–5.4%) [citations omitted; emphasis added].
  9. ↑ Darves-Bornoz JM, Alonso J, de Girolamo G, de Graaf R, Haro JM, Kovess-Masfety V, Lepine JP, Nachbaur G, Negre-Pages L, Vilagut G, Gasquet I (October 2008). "Main traumatic events in Europe: PTSD in the European study of the epidemiology of mental disorders survey". Journal of Traumatic Stress. 21 (5): 455–462. doi:10.1002/jts.20357. PMID 18956444. In univariate analyses adjusted on gender, six events were found to be the most significantly associated with PTSD ( p < .001) among individuals exposed to at least one event. They were being raped (OR = 8.9), being beaten up by spouse or romantic partner (OR = 7.3), experiencing an undisclosed private event (OR = 5.5), having a child with serious illness (OR = 5.1), being beaten up by a caregiver (OR = 4.5), or being stalked (OR = 4.2)" [OR = odds ratio].
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