PTSD – Thinking Outside the Box

People usually think of PTSD as something you develop if you go to war, are sexually assaulted or suffer a similar easily identifiable trauma. However there is research showing that PTSD does happen in other circumstances. For example, Chan, et al. (2017) study of the course and predictors of post-traumatic stress disorder in a cohort of psychologically distressed patients with cancer found that  the overall rates of PTSD decreased with time. However, they concluded that, one-third of patients (34.1%) who were initially diagnosed had persistent or worsening PTSD 4 years later.

Similarly, Farren et al. (2016) studied post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy and they reported  that large number of women having experienced a miscarriage or ectopic pregnancy fulfil the diagnostic criteria for probable PTSD. In the same vein, Bienvenu et al. (2013) study of post-traumatic stress disorder symptoms after acute lung injury* was conducted over a 2-year period. They found that during the 2-year follow-up, 66/186 patients (35%) had PTSD symptoms, with the greatest prevalence by the 3-month follow-up. Fifty-six patients with post-acute lung injury PTSD symptoms survived to the 24-month follow-up, and 35 (62%) of these had PTSD symptoms at the 24-month follow-up. Kim et al. (2015) study found that there are also high rates of PTSD (up to 25% )  amongst mothers with infants admitted to the Neonatal Intensive Care Unit after birth.

Sricharoenchai et al. (2014) meta analysis  of  28 articles representing 3,437 patients admitted to ICU found that PTSD symptoms occurred in 25% to 30% of ICU survivors over 1-year follow-up, especially in those who were young, received benzodiazepines, and had post-ICU memories of frightening ICU experiences.

PTSD presentations can be varied, keeping an open mind to the possibility of “unconventional” presentations of PTSD may serve clients well.

*(Acute lung injury is a condition marked by excessive fluid in the lungs and frequent multi-organ failure. It can involve airway collapse, and often requires the use of a mechanical ventilator to stay alive)


Bienvenu, O., Gellar, J., Althouse, B., Colantuoni, E., Sricharoenchai, T., Mendez-Tellez, P., . . . Needham, D. (2013). Post-traumatic stress disorder symptoms after acute lung injury: A 2-year prospective longitudinal study. Psychological Medicine, 43(12), 2657-2671. doi:10.1017/S0033291713000214

Chan, C. M. H., Ng, C. G., Taib, N. A., Wee, L. H., Krupat, E. and Meyer, F. (2017), Course and predictors of post-traumatic stress disorder in a cohort of psychologically distressed patients with cancer: A 4-year follow-up study. Cancer. doi: 10.1002/cncr.30980

Farren, J., Jalmbrant, M., Ameye, L., Joash, K., Mitchell-Jones, N., Tapp, S., Timmerman
D., Bourne, T. (2016). Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study. BMJ Open, 6(11), e011864.
Kim WJ, Lee E, Kim KR, Namkoong K, Park ES, Rha DW. Progress of PTSD symptoms
following birth: a prospective study in mothers of high-risk infants. J
Perinatol. 2015 Aug;35(8):575-9. doi: 10.1038/jp.2015.9. Epub 2015 Apr 9. PubMed
PMID: 25856762.
Sricharoenchai, T., Parker, A. M., Raparla, S., Schneck, K., Bienvenu, O. J., & Needham, D. M. (2014). B23 CLINICAL TRIALS AND OUTCOMES: A meta-analysis of post-traumatic stress disorder (ptsd) symptoms in intensive care unit survivors. American Journal of Respiratory and Critical Care Medicine, 189, 1. Retrieved from