Life events lead to more symptoms of post-traumatic stress disorder than traumatic events

Life events (e.g. divorce, unemployment) can generate more symptoms of post-traumatic stress disorder (PTSD) than traumatic events (e.g. a road accident, war), according to a new study.

PTSD is the only psychiatric condition that requires a specific event to have occurred for its diagnosis. The aims of this study from The Netherlands, published in the June issue of the British Journal of Psychiatry, were to gather evidence from the general population on whether life events generate as many symptoms of PTSD as traumatic events.

Information on demographic characteristics and history of stressful events was collected through a written questionnaire sent to a random sample of 2997 adults aged 20 and over. Respondents also filled out a PTSD symptom checklist, keeping in mind the worst event that had ever happened to them. Half of the questionnaires were returned.

Of the 1498 respondents, 832 were eligible for inclusion in the study, which compared average PTSD scores after traumatic v. life events. Reasons for exclusion were not having experienced any event, not having specified one's worst event, or having chosen more than one worst event.

There were 299 respondents whose worst event could be classified as traumatic, and 533 whose worst event was a life event. Those whose worst event was traumatic experienced it 18 years ago on average, compared with 12 years ago for those whose worst event was a life event.

It was found that for events from the past 30 years, the PTSD scores were higher after life events than after traumatic events. For earlier events, the scores were similar for both types of event.

The authors of the study comment that this research is the first to show that people from the general population whose worst event is a life event, such as chronic illness, marital discord or unemployment, on average have more PTSD symptoms from this event than people whose worst event is traumatic, such as an accident or a disaster.

This finding holds true for events that occurred at some time in the past 30 years. It may be that in the very long run the impact of a life event 'wears out' in terms of PTSD, whereas that of a traumatic event is more persistent.

Further research is needed to explore the reasons for the unexpected findings of this study.