Understanding Post-Traumatic Stress Disorder: Causes and Incidence

This study aims to understand the causation and incidence of post-traumatic stress disorder also known as PTSD in wart veterans, sexually abused and victimized people, and physically abused people and how violence plays a huge etiological role in development of PTSD in later stages of life or rather after the violent episode has passed away.

RUNNING HEAD: POST TRAUMATIC STRESS DISORDER
POST TRAUMATIC STRESS DISORDER
PART 3
RESEARCH PAPER
Name of Student
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1POST TRAUMATIC STRESS DISORDER
Table of Contents
ABSTRACT...............................................................................................................................2
Post-Traumatic Stress Disorder..................................................................................................3
Sexual Trauma and PTSD......................................................................................................3
Military Combat and PTSD...................................................................................................5
Witnessing Violence and PTSD.............................................................................................7
RESEARCH QUESTIONS........................................................................................................8
Literature review........................................................................................................................8
Introduction................................................................................................................................8
Literature review......................................................................................................................11
Annotated bibliography............................................................................................................14

2POST TRAUMATIC STRESS DISORDER
ABSTRACT
This study aims to understand the causation and incidence of post-traumatic stress
disorder also known as PTSD in wart veterans, sexually abused and victimized people, and
physically abused people and how violence plays a huge etiological role in development of
PTSD in later stages of life or rather after the violent episode has passed away. The various
psychological tools and sociological tools have been applied in the recent decades to analyze
the affection of individual with post-traumatic stress disorder (Blessing et al., 2018). This
research study actively engages in understanding the other researches already performed in
the same area of study and takes into account, the reasoning and revelations made by medical
and psychological literature, in the recent decades. In this study, a population of veterans, old
people, young women and children are focused in order to understand the deepest aspects of
psychological, physical and sexual trauma inflicted. The study takes into perspective, various
psychological, social aspects and finds out the psychosocial measures that can be helpful to
eliminate the dreadful effects of PTSD – two of which can be signified as suicidal attempts
and self harm behaviors as well.

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Post-Traumatic Stress Disorder
PTSD can be considered as a Condition which creates in certain individuals who have
encountered some sort of shocking, unnerving, or a perilous occasion in life. It is normal to
feel apprehensive during and after the traumatic circumstance (Hinton & Good, 2016). Any
sort of Fear responses consistently triggers a large number of the brief instant changes in the
body to help safeguard against risk or to maintain a strategic distance from it. This adrenaline
driven fight or flight reaction comes to an overt expression to rescue the individual from
damage. About everybody will encounter a scope of responses after traumatic episode, yet a
great many people recuperate from introductory side effects normally. The individuals who
keep on encountering issues might be determined to have PTSD. Individuals with PTSD can
feel pushed or even scared, notwithstanding when the danger has passed away (Kessler et al.,
2017). Few out of every odd and each damaged individual create chronic or even a
momentary sort of acute PTSD. It isn't that everybody with PTSD has experienced a
hazardous occasion. There are certain conditions that can primarily lead to PTSD which are
sexual trauma, military combat, witnessing violence. This study focuses chiefly on PTSD as
because it has led to various suicidal attempts and self-harm behaviors across the decades and
it is time, that scientific research must focus on the problem, profoundly from all perspective
so as to take measures against it.
There are certain sub- areas that the research focuses on while studying PTSD in all
its aspects.
Sexual Trauma and PTSD
Sexual Abuse in kids is a significant social issue globally. In a meta-investigation of
around two hundred and seventeen distributions that originated from various different nations
distributed between the time of 1980 and of 2008 assessed the commonness pace of about

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Sexual type of abuse before an age of 18 was observed to be eighteen percent for that of
women and furthermore 7.6% for that of men. The reports elucidated factors about youthful
sexual victimization and violence that was identified with different retrospective
investigations of adult examples (Breiding et al., 2015). The given outcomes show in all
respects unequivocally that sexual maltreatment of kids is connected to the multiple sorts of
different long haul results. Insightful literature reviews reasoned that sexual abuse cases is a
non-explicit hazard factor for a range of psychosocial issues and simply mental issues like
sorrow, the Suicidal Tendencies, Anxiety Disorders and of course PTSD, just as the physical
issues just as risky sexual practices.
Notwithstanding the expansion of concentrates regarding this matter in the course of
recent years, our insight into the transient results among youth having encountered sexual
abuse occurrences stays restricted. Subsequently indeed these youths enlisted in intercession
and treatment focuses following revelation show large amounts of differential psychological
pain. Studies of PTSD identified revealing factors with huge personality dissociation side
effects (Krause-Utz et al., 2018) and the externalization of behavioral problems (like the
medication misuse, the direction issue, the misconduct), just as hazardous sexual practices
(early beginning of initial sexual relations, numerous sexual accomplices alongside
unprotected sex) in different sexually abused teenagers.
Well beyond the differing results related with Sexual abuse, the PTSD side effect
seems, by all accounts, to be one of the cardinal groupings of traumatic signs most habitually
and continuously experienced by casualties of any sexual abuse. The analytic criteria of post-
traumatic stress disorder issues are characterized by manifestations of the intrusion,
avoidance in relationship betterment (Cloitre, Jackson & Schmidt, 2016) lead to more
traumas and furthermore hyper-arousal. An audit of concentrates distributed between the time
of 2000 and the time of 2011 about pre-adulthood cases of PTSD and was revealed that 57%

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of adolescents who encountered any kind of sexual victimization - had the very indications of
post-traumatic stress disorder. In the empirical investigations – it was found that PTSD or
post-traumatic stress disorder affected young people greatly in their advancing years and
continued to haunt them in later years and the females who could form good relationships
with any other male partner, afterwards , recovered faster from PTSD.
Military Combat and PTSD
Serving for United States Army gives a significant chance to the sociological sense,
the having a place sense and a mindfulness. The re-foundation of new sociological sense is
fundamental for veterans who are progressing from military to a much needed civilian life. In
any case, the improvement of new connectedness sense is one of numerous difficulties
isolating the administration individuals may confront (Head et al. 2016). Little is thought
about the major function of Social-connectivity may play in advancing positive social
transition results.
One such test progressing Veterans may experience is neglected psychological well-
being needs, especially in Posttraumatic-Stress issue or PTSD circumstances. The Evidence
proposes that veterans are particularly in danger of building up any indications of PTSD
because of the potential sort of stressors related with the combative exposure identified with
military-related traumatic type of experience (Kintzle et al., 2018). The very manifestations
of PTSD are described by nosy Thoughts in which the excitatory trauma is kind of re-
experienced alongside avoidance (Brockman et al., 2016) endeavors of circumstances that
may trigger the injury, a type of over alertness or the hyper-excitement remains about
negative adjustments in the cognition processes and dispositional processes which may cause
again lead to aggression. The veterans with the traumatic history and the PTSD alongside
episodes of insomnia, mood Shifts, disruptive behavior, any history of substance use and the
social-isolation which may obstruct the effective progress from the army to the civilian's life.

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One of the essential hazard factors for PTSD led symptoms is a combative
representation. Broad research concentrates distinguishes the contentious introduction as a
robust indicator of physical-wellbeing and the psychosocial inconveniences in the Veterans
because of the danger of any physical damage, any mental type or psychosocial type injury
and the different stressors that are identified with wartime. An ongoing report analyzed
relationship between combative Exposure and mental, physical wellbeing focuses well on
PTSD cases and that is because of a complex psycho-physical pain and resultant depression
in the veterans (Brockie et al., 2015). The different discoveries demonstrate that veterans
presented to the fluctuating combative situations had more prominent Pain power and
therefore higher PTSD and sadness side effects in examination veterans with no combating
presentation.
Another factor related with negative results of sociological transition is non-
Honorable type of status while getting discharged. As capability for advantages is dictated by
the very discharge status, the generally sixteen percent of the veterans who leave the army
with non-honorable status of discharge. War. Veterans with discharge status that was
extremely non-honorable are at expanded danger of unfavorable mental human conditions
resulting from PTSD. Among the difficulties that Military Veterans experience during their
Social-Transition from military to non-military personnel life is lost social-sociological. The
Social-availability alludes to a person's interior feeling of having a place identity in
association with the social condition. Social-sociological impacts the exceptionally Inter-
personal connections, the Peer bonds, Pro-Social conduct and the general status of Socially-
dynamic Integration all through their life expectancy. There are the wellbeing and the
Psychological Advantages connected to Social-sociological.
The motivation behind this investigation is to investigate the impact of Combating
presentation, Discharge status (Non-Honorable) and the social-availability on PTSD side

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effects in people who have served in the United States military. Existing study researches
demonstrates that encountering of a higher feeling of the social-sociological security may fill
in as a defensive factor against mental trouble, the depressive symptoms identified with
PTSD (Kimbrel et al., 2016) and furthermore low levels of self-esteem that prompted the
suicidal plans. With the misfortune a community sense, social identity and the belonging
sense regularly given by the military, the powerlessness to locate another feeling of social-
sociological may make trouble for veterans communicating in the non-military personnel
society.
Witnessing Violence and PTSD
Studies and different researches on these war veterans detailed a critical kind of
relationship between the level of PTSD and the neuroticism levels that exist after and before
any trauma presentation. The relationship has been affirmed different consume unfortunate
casualties and the older persons with the myocardial Infarction. The outcomes concerning the
other four types of traits in personality and their vivid relationship with the progressive
development of Post-traumatic stress disorder are as very much conflicting. As indicated by a
longitudinal research on oneself revealed, the Adverse life occasions and longitudinal
changes in the personality traits based out of Five-Factor Model (Trautmann et al., 2015),
directed on a urban example, coming up next are the indicators of poor emotional wellness
after Violence presentation to injury: a lower score on the extraversion levels or a
Conscientiousness level at the standard, builds the degree of and for neuroticism. In these
elder individuals with any myocardial Infarction and furthermore PTSD, with high
neuroticism score - they scored lower on levels of agreeableness when they were contrasted
with the members without indications of PTSD.
With regards to wartime, the women among Civilian mass can be presented to
indistinguishable Traumatic encounters from the dynamic troopers (who were engaged with

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Bombarding and Missiles), yet women might be moreover presented to a wide scope of
explicit Gender-Based demonstrations of violence like domination, constrained pregnancy,
sexual subjugation, assault in addition to constrained prostitution in wartime. The present
investigation scrutinizes and looks at the connection between the levels of early injury, the
presentation to character attributes, the forms of war-driven injury and the various kinds of
PTSD side effects among the female war victims following ten years after Croatian war. In
view of past research, it was theorized that a higher presentation to early injury in mixes with
a higher number of war-related horrendous mishaps would be indicators of posttraumatic
stress manifestations. It was likewise estimated that personality traits in and from the five-
factor model, particularly higher Neuroticism scores and lower levels of Conscientiousness
scores, Extraversion, Openness and Agreeableness would clarify the extra fluctuation found
or revealed in Posttraumatic symptomatology cases amongst the different traumatized
women.
RESEARCH QUESTIONS
The questions are as follows:-
1. How is sexual violence and victimization related to PTSD?
2. How is wartime memory of physical violence lead to PTSD?
3. How does any form of violence received at a young age impacts psychosocial aspects
of life as PTSD in the later stages?
Literature review
Introduction
PTSD has given a considerable effect on the individual and the general public. There
has been developing proof showing that, among these Anxiety issue, the PTSD is one of the

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most firmly connected with any suicidal attitude or self-harm conduct, even subsequent to
modifying for different types of classifications in I and II mental disorders. Various kinds of
data from a few longitudinal type and Cross-sectional type of scientific studies have
reproduced these clinical findings. Around twenty seven of the persons with PTSD
additionally and truly conflict with perspectives relating to interpersonal communication,
have difficult parenting issues, and any number of decreases inside the household salary with
psychological wellness comorbidities. The epidemiologic examples in sociological researches
have exhibited that over a daunting 90% of individuals with PTSD have in any event one
comorbid mental issue in whole lifetime. Probably the most pervasive comorbid conditions
with PTSD are liquor abuse, behavioral and psychosocial turmoil with a strong social tension
issue. Any self-medicine practice and abuse in PTSD manifestations with alcohol and drug
abuse has been exhibited to be related with comorbid cases of alcohol and in drug-use issues.
Amongst the axis II type of mental issues and the disorders, there has been expanding amount
of proof that PTSD has been observed to be related with the marginal character or a solitary
character issue. It is conceivable that personality styles related with level of impulsivity may
put the individual in danger of presentation to the traumatic circumstances.
The fighting Veterans residing in the all-inclusive community have demonstrated that
PTSD is related with Physical Ailments. Traumatic Brain Injury or TBI has been
demonstrated to be a significant Risk factor for improvement of PTSD. It is very much
relevant that PTSD symptom expands the chances of danger of creating physically active
medical issues through insomnia, obesity, or advancement of the comorbidity levels with
Depression and AOD abuse (Juhnke, 2017). On the other hand, the unexpected beginning of
a genuine Life-undermining ailment like Myocardial Infarction (MI), can trigger indications
of PTSD manifestations. Sociological variables like condition, neediness in addition to
hereditary qualities can assume basic job being developed cases of comorbidity levels.

10POST TRAUMATIC STRESS DISORDER
Despite the fact that there has been extension of our comprehension of PTSD during the most
recent thirty to forty years, various questions stay about epidemiology and hazard factors for
improvement of PTSD. Essential inquiries regarding how regular PTSD is stay still
unanswered. The majority of the investigations on the pervasiveness of PTSD have utilized as
a rule that the population or Veteran examples. The predominance of PTSD among
vulnerable collections like the adolescents, old, youngsters, the ethnic masses, the socially
displaced people, the First Nations needs more research and studies. Any amount of future
work needs to address these significant holes. In spite of the fact that, there are various
entrenched, population type level hazard factors for improvement of PTSD, the estimation of
hazard for PTSD at an individual level is inadequate. The expectation Algorithms have been
created for MI (with Framingham Heart Study) in addition to sorrow. Further, any kind of
longitudinal course for PTSD occurrences has not been entrenched. One progressively
Epidemiologic Research of youthful Adults found that half of individuals with a PTSD
finding kept on gathering criteria three years after the fact. Individuals enduring with the
PTSD side effects is hesitant to talk about Traumatic occasion and give subtleties. The
Psychiatric Assessment can be deliberately considered for the PTSD indications sway on the
individual's pattern of wakefulness and sleep, other circadian rhythms and the types in social
relationships.
Like other types of critical mental issues, the treatment of PTSD ordinarily requires a
mix of the mental (psychological) and the pharmacological treatment. The psychological
interventions for PTSD is considered as the first-line of treatment in the PTSD situations and
have been appeared to have bigger impact estimates in the randomized control trials than any
pharmacotherapy levels. Cognitive behavioral therapies (Brown et al., 2018) alongside with
ocular movement desensitization with the best evidence based reprocessing treatment is more
compelling than various randomized control trials that have demonstrated huge decreases in

11POST TRAUMATIC STRESS DISORDER
the prevalence of PTSD side effects (Cordova, Riba & Spiegel, 2017). Be that as it may, for
most patients with PTSD, access to prove based treatments is not that simple attributable to a
predetermined number of prepared advisors. There is a critical need to consider novel
approaches to make the CBT increasingly applicable. As of late, RCT in essential
consideration showed the adequacy of conveying Cognitive Behavioral Therapy for
nervousness issue in cases of PTSD by the insignificantly prepared concerned clinicians is a
huge question. An essential consideration given by clinicians had negligible preparing in
Cognitive behavioral therapy and conveyed measure of CBT with the very help of the patient
care program. These kinds of novel methodologies for conveying EBP treatments to huge
populaces require replication in Canadian settings.
Literature review
Van der Kolk (2017) aims to study ‘Developmental Trauma Disorder: Toward a
rational diagnosis for children with complex trauma histories’. The children exposed to
alcoholic parents or domestic violence rarely have secure childhoods; their symptomatology
tends to be pervasive and multifaceted and is likely to include depression (Smoller, 2016)
various medical illnesses, and a variety of impulsive and self-destructive behaviours. The
traumatic stress field has adopted the term “complex trauma” to describe the experience of
multiple, chronic and prolonged, developmentally adverse traumatic events, most often of an
interpersonal nature (as for example sexual or physical abuse, war, community violence) and
early-life onset.
Pico-Alfonso et al. (2006) aims to study ‘The Impact of Physical, Psychological, and
Sexual Intimate Male Partner Violence on Women's Mental Health: Depressive Symptoms,
Posttraumatic Stress Disorder, State Anxiety, and Suicide’. In this study, intimate male
partner violence along with male partner’s dominance on the female partner and sexual

12POST TRAUMATIC STRESS DISORDER
trauma inflicted lead to various symptomatology of PTSD in the women later on. These
PTSD symptoms involved re awakening of stress anxiety associated with the past sexual
trauma received and this led to increased level of depression and depressive symptoms in the
victimized women, afterwards in their life. Physical violence was always associated to some
degree with the intensity of sexually inflicted trauma and the study implied on a positive
social support as an intervention.
Campbell et al. (2008) aimed to study ‘The co-occurrence of childhood sexual abuse,
adult sexual assault, intimate partner violence, and sexual harassment: A meditational model
of posttraumatic stress disorder and physical health outcomes’. The study was performed on
268 African American female veterans. The study focused on two different areas – firstly on
the memories of childhood traumas – both physical and sexual and the adulthood traumas
(mainly sexual). The rate of victimization, re-victimization was determined by the study and
certain themes were drawn to decipher the differential rates of trauma received by each
individual women owing to their differential levels of perception and sensation and memory
retrieval. While, these lead to symptoms of severe post-traumatic stress disorder amongst the
African American females – psychological and social support interventions was
recommended by the study.
Hautamäki & Coleman (2001) aims to give ‘explanation for low prevalence of PTSD
among older Finnish war veterans: social solidarity and continued significance given to
wartime sufferings’. This was another interesting study done by the researchers who aimed to
understand the sociological dynamics in, during and after the war periods and how these
dynamics can affect the war veterans in an adverse or positive way. The study was focused
on the Finnish war theme and the data was analyzed to reveal that comparatively to other war
experienced veterans of other nationalities who experienced PTSD of high levels long after
the war has been over – this Finnish veteran population experienced lesser symptoms of post-

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traumatic stress disorder or rather lesser prevalence of post-traumatic stress disorder. This
was increasingly due to a reciprocal loyalty (Livnat & Kohn, 2018) exhibited by Finnish
veterans, reciprocal kinship and collective appreciation for each other’s participation in the
war that existed in the Finnish community and culture lead to the diminished prevalence of
PTSD.
Raji et al. (2015) aimed to study ‘Functional neuroimaging with default mode
sociological regions distinguishes PTSD from TBI in a military veteran population’. The
study uses SPECT imagining to differentiate between the affections of post war veterans with
traumatic brain injury and post-traumatic stress disorder. The study took gender, age,
nationality into criterion to study the causations of TBI and PTSD in terms of sensitivity,
accuracy and specificity and it was found that the prevalence of PTSD was 90 – 95 percent
more accurate, specific and sensitive to TBI in any of these veterans.
Johnston (2000) aims to study ‘A series of cases of dementia presenting with PTSD
symptoms in World War II combat veterans’. The study was conducted the experiences of
world war two Korean veterans and the sample included the veterans who more than equal to
68 years old and there symptoms of Post-traumatic stress disorder which were reported to be
stimulated by war nightmares, hyperactivity of the physiological responses lead to
exaggerated responses in addition to pallor and acute confusion states to war evocative
stimulus. There were reported sudden outbursts of PTSD caused dysphoria (Van Duse et al.,
2015), preoccupation and exaggerated sadness. The episodes of PTSD affection was recorded
by this research study and further analysis was done to prevent the same.
Koven (2017) aims to study ‘PTSD and suicides amongst Veterans - Recent Findings.
In this study the military people coming back from battlefield’s were given focus and studied
for economic, ethical and sociopsychological consequences’. The study focuses on war

14POST TRAUMATIC STRESS DISORDER
related trauma, the memories and the nightmares. The center point of the study remains with
the level of suicidal attempts and suicidal cases in related to victimization in the war and
trepidations of the wartime violence. The study uses strong sociological and war philosophy
reasoning techniques to understand how peace and war is interrelated and how the connection
between the two lead to development of biases in social settings and causation of PTSD.
Thabet, Thabet & Vostanis (2016) aims to study ‘The relationship between War
Trauma, PTSD, Depression, and Anxiety among Palestinian Children in the Gaza Strip’. The
study focuses on the understanding of how the act of continuous bombardments and shooting
and the sensory stimuli relating to level of bombardments sound received every day and
night, by the children residing in the aforementioned areas, are affected by the war trauma.
The study researches how the chain of war events in these areas lead to development of
anxiety, fear, frustration and stress amongst these children affected their mental and physical
health (Herzog, Farchi & Gidron, 2018). The information has been assembled to understand
phenomenon of PTSD amongst the Palestine children.
Annotated bibliography
Article name: Developmental Trauma Disorder
Author name: Bessel A. van der Kolk, MD
Link: https://www.healio.com/psychiatry/journals/psycann/2005-5-35-5/%7B3119e8d0-bf35-
4e6d-b8f6-aa9f3c6720b0%7D/developmental-trauma-disorder-toward-a-rational-diagnosis-
for-children-with-complex-trauma-histories
This research article focuses on post traumatic developmental disorder (PTSD)
through the ideation of developmental trauma disorder. Developmental trauma disorder is
explained from the perspective that the traumas received the childhood tends to embed itself
in memories and reiterate itself through the other experiences and encounters of life. The

15POST TRAUMATIC STRESS DISORDER
nature of the trauma – as in physical, emotional or sexual is critically discussed in the
research article and how the same relates to progression of post-traumatic stress disorder
symptoms later in the life. The causation of PTSD has been described as a developmental
complexities embedded in the psychological and psychosocial sphere (Bar-Shai & Klein,
2015). The limitation of the study is that it uses qualitative data analysis and a sound support
from quantitative data is missing. A mixed method study would have been apt for this kind of
research study. The childhood traumatic experiences and the developmental aspect of
psychology has been highlighted throughout a study – providing an implication that further
researches needs to focus on childhood experiences and behavioural attitudes in order to
decipher the aetiology of post-traumatic stress disorder, expressing in later stages of life. The
strength of the study is the aspect from which it sees the causation or development PTSD
from.
Article name: The co-occurrence of childhood sexual abuse, adult sexual assault, intimate
partner violence, and sexual harassment
Author name: Campbell, Rebecca,Greeson, Megan R.,Bybee, Deborah,Raja, Sheela
Link: The co-occurrence of childhood sexual abuse, adult sexual assault, intimate partner
violence, and sexual harassment: A mediational model of posttraumatic stress disorder and
physical health outcomes.
The research article focuses chiefly on sexual victimization and sexual-harassment in
childhood stage and the way it related to adulthood sexual behaviors which is unsafe and
even violent as well. Various psychological aspects and intricacies involved in an intimate
relationship between two persons is critical and the study emphasizes on the relationship
nature between two adult people that lead to the causation of post-traumatic stress disorder
(Lateh, Ahmad & Mohamad, 2018). The limitation of the study is that it only focuses on the

16POST TRAUMATIC STRESS DISORDER
psychological aspects of the problem PTSD rather than the sociological aspects and
influences of the same. The study implies that female gender is more affected from sexual
trauma as compared to the male gender and the strength of the research is that it elucidates
the intricacies between male and female psyche and nature of trauma that impacts in a very
gender specific way.
Article name: PTSD and Suicides Amongst Veterans—Recent Findings
Author name: Steven G. Koven
Link: https://psycnet.apa.org/buy/2008-03290-003
The study focuses on the wartime memories affecting the military veterans later on, in their
personal lives. The social transition is the centre point of the search study and how social
incompetency and painful memories lead to ideation of suicidal tendencies (Blakey et al.,
2018). form the underpinning of the research. The limitation of the research is the fact that
the study older researches and old references to support the discussion in the study. The study
implies that a positive social interaction has to be taken into consideration as a measure by
the support members and the clinicians into in order to intervene PTSD in an effective way.
The study implies a positive family support to be crucial in the case management.

17POST TRAUMATIC STRESS DISORDER
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