Diagnoses of post-traumatic stress disorder among college students more than doubled between 2017 and 2022, and rose most sharply when the coronavirus pandemic closed campuses and upended the lives of young adults, according to new research released Thursday.
The prevalence of post-traumatic stress disorder increased from 3.4 percent to 7.5 percent during that period, according to the results. 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 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. That’s why 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 to the coronavirus.
Post-traumatic stress disorder is a mental health disorder characterized by intrusive thoughts, flashbacks, and increased sensitivity to reminders of an event, which continues more than a month after it occurs.
It’s a relatively common disorder, and an estimated 5 percent of adults in the United States experience 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 percent in women and 4 percent 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 rose to 0.7 percent among college students in 2022, up from 0.2 percent five years earlier.
Mental health care use increased nationally during the pandemic, since teletherapy made consulting doctors much easier. Treatment for anxiety disorders rose most sharply, 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.
Post-traumatic stress disorder was introduced as an official diagnosis in 1980, when it became clear that combat experiences had left their mark on many Vietnam veterans, making it difficult for them to work or participate in family life. During the following decades, the definition was revised to encompass a broader range of injuries, violence and abuse, as well as indirect exposure to traumatic events.
However, the diagnosis still requires exposure to 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 uncommon for young adults 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. It then declined precipitously after age 20.
Research suggests that less than one-third of people exposed to traumatic events develop PTSD.
Shannon E. Cusack, an academic researcher who has studied post-traumatic stress disorder in college students, said there was division within the field over whether the profound disruptions young adults experienced during the pandemic — abrupt loss of housing and income, social isolation and fear of infections) are equivalent to triggering events.
“They are causing symptoms that are consistent with the diagnosis of PTSD,” said Dr. Cusack, a clinical psychologist and assistant professor of psychiatry at Virginia Commonwealth University. “I’m not going to treat them because their stressor doesn’t count as trauma?”
Prevalence data, he said, point to a pressing need for PTSD treatment on college campuses. Short-term treatments developed for veterans, such as prolonged exposure therapy and cognitive processing therapy, have been shown to be effective in managing symptoms of post-traumatic stress disorder.
Stephen P. Hinshaw, a psychology professor at the University of California, Berkeley, said the pandemic’s disruptions may have left college students emotionally drained and less resilient to traumatic events.
“Halfway through this study, there may legitimately have been more trauma and deaths,” he said, adding that the lockdowns may have caused more widespread despair among young people. “With the overall decline in mental health, is it more difficult to cope with traumatic stressors if one is exposed to them?”
Some changes to the diagnostic manual may have blurred the line between PTSD and disorders like depression or anxiety, Dr. Hinshaw said. In 2013, the committee overseeing revisions to the manual expanded the list of possible PTSD symptoms to include dysphoria, or a deep sense of restlessness, and a negative view of the world, which could also be caused by depression, he said. But the changes, he added, do not take into account the sharp increase in diagnoses.
