PTSD is on the rise among college students

Diagnoses of post-traumatic stress disorder among college students more than doubled between 2017 and 2022, rising the most as the coronavirus pandemic shut down campuses and upended young lives, according to a new study published Thursday. .

The prevalence of PTSD increased to 7.5 percent from 3.4 percent during that period, according to the findings. Researchers analyzed responses from more than 390,000 participants in the Healthy Minds Study, an annual Internet-based survey.

“The magnitude of this increase is truly staggering,” said Yusen Zhai, the paper’s lead author, who directs the community counseling clinic at the University of Alabama at Birmingham. His clinic had seen more young people struggling after traumatic events. So he expected an increase, but not that big.

Dr. Zhai, an assistant professor in the Department of Human Studies, attributed the increase to “broader social stressors” among college students, such as campus shootings, social unrest and the sudden loss of loved ones to the coronavirus.

PTSD is a mental health disorder characterized by intrusive thoughts, flashbacks, and heightened sensitivity to memories of an event that persists more than a month after it occurs.

It’s a relatively common disorder, with about 5 percent of adults in the United States experiencing it in any given year, according to the most recent epidemiological survey conducted by the Department of Health and Human Services. Lifetime prevalence is 8 percent in women and 4 percent in men, the survey found.

The new research also found a sharp increase in the prevalence of a similar condition, acute stress disorder, which is diagnosed less than a month after a trauma. Diagnoses rose to 0.7 percent among college students in 2022, up from 0.2 percent five years ago.

Use of mental health care increased nationally during the pandemic, as teletherapy made it much easier to see doctors. Treatment for anxiety disorders grew the most, followed by PTSD, bipolar disorder and depression, according to economists who analyzed more than 1.5 million insurance claims for doctor visits between 2020 and 2022.

PTSD was introduced as an official diagnosis in 1980, after it became clear that combat experiences were embedded in many Vietnam veterans, making it difficult for them to work or participate in family life. Over the following decades, the definition was revised to include a wider range of injuries, violence and abuse, as well as indirect exposure to traumatic events.

However, the diagnosis still requires exposure to a Criterion A trauma, defined in the Diagnostic and Statistical Manual of Mental Disorders as “death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence.”

It is not unusual for young people to experience traumatic events. A 1996 study of Detroit residents found that exposure to traumatic events—such as violent assault, injury, or sudden death—peaked sharply between the ages of 16 and 20. It then declined sharply after the age of 20.

Research suggests that less than one-third of people exposed to traumatic events go on to develop PTSD.

Shannon E. Cusack, an academic researcher who has studied PTSD in college students, said there was a divide within the field over the profound disruptions young people experienced during the pandemic — sudden loss of housing and income, social isolation and fear of infection. – constitute triggering events.

“They are causing symptoms that are consistent with a diagnosis of PTSD,” said Dr. Cusack, a clinical psychologist and an assistant professor of psychiatry at Virginia Commonwealth University. “Am I not going to treat them because their stress doesn’t count as trauma?”

The prevalence data, she said, point to an urgent need for PTSD treatment on college campuses. Short-term treatments developed for veterans, such as prolonged exposure therapy and cognitive processing therapy, have proven effective in managing PTSD symptoms.

Stephen P. Hinshaw, a professor of psychology at the University of California, Berkeley, said the pandemic’s disruptions may have left college students emotionally depleted and less resilient when faced with traumatic events.

“In the midst of this study, there may legitimately have been more trauma and death,” he said, adding that the lockdowns may have caused more general despair among young people. “With overall worsening of mental health, is it harder to cope with traumatic stressors if exposed to them?”

Some changes in the diagnostic manual may have blurred the line between PTSD and disorders such as depression or anxiety, said Dr. Hinshaw. In 2013, the committee overseeing revisions to the manual expanded the list of possible PTSD symptoms to include dysphoria, or a deep sense of uneasiness, and a negative worldview, which can also be caused by depression, he said. But the changes, he added, do not account for the sharp increase in diagnoses.