PTSD diagnoses among college students more than doubled between 2017 and 2022, rising most sharply as the coronavirus pandemic shuttered campuses and upended students' lives, according to new research released Thursday. young adults.
According to the findings, the prevalence of PTSD rose to 7.5% from 3.4% during that period. Researchers analyzed responses from more than 390,000 participants in the Healthy Minds Study, an annual web-based survey.
“The magnitude of this increase is truly shocking,” said Yusen Zhai, the study's lead author, who directs the community counseling clinic at the University of Alabama at Birmingham. His clinic had seen multiple young people struggle following 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” for college students, such as campus shootings, social unrest and the sudden loss of loved ones due to coronavirus.
PTSD is a mental health disorder characterized by intrusive thoughts, flashbacks, and increased sensitivity to memories of an event, which continues for more than a month after it occurs.
It is a relatively common disorder, with about 5% of adults in the United States experiencing it in a given year, according to the most recent epidemiological survey conducted by the Department of Health and Human Services. The lifetime prevalence is 8% in women and 4% in men, according to the survey.
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 increased to 0.7% among college students in 2022, up from 0.2% five years earlier.
Mental health care use has increased nationwide during the pandemic, as teletherapy has made it much easier to see doctors. Treatment for anxiety disorders has increased fastest, followed by post-traumatic stress disorder, 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, when it became clear that combat experiences had left a mark on many Vietnam veterans, making it difficult for them to work or participate in family life. Over the next several decades, the definition was revised to include a broader 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 assault.”
It is not uncommon 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 unexpected death – peaked between ages 16 and 20, then declined precipitously after age 20.
Research suggests that less than a third of people exposed to traumatic events develop post-traumatic stress disorder.
Shannon E. Cusack, an academic researcher who has studied PTSD in college students, said there is division within the field over whether the profound upheavals experienced by young adults during the pandemic – sudden loss of housing and income, social isolation and fear of infections – equate to triggering events.
“They are causing symptoms consistent with the diagnosis of post-traumatic stress disorder,” said Dr. Cusack, a clinical psychologist and assistant professor of psychiatry at Virginia Commonwealth University. “I won't treat them because their stressor doesn't count as trauma?”
The prevalence data, he said, indicates 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 psychology professor at the University of California, Berkeley, said the upheavals of the pandemic may have left college students emotionally depleted and less resilient in the face of traumatic events.
“Over the course of this study, there may legitimately have been more trauma and deaths,” he said, adding that the lockdowns may have caused more general despair among young people. “With the general deterioration of mental health, is it more difficult to cope with traumatic stressors if one exposes oneself to them?”
Some changes to the diagnostic manual may have blurred the line between post-traumatic stress disorder and disorders such as depression or anxiety, Dr. Hinshaw said. In 2013, the committee overseeing revisions to the manual expanded the list of potential PTSD symptoms to include dysphoria, a profound sense of unease, and a negative worldview, which could also be caused by depression, he said. But the changes, he added, do not take into account the sharp increase in diagnoses.