What Is PTSD?
- Most people experience some type of traumatic event in their lifetime. This may be a car crash, a serious injury, a physical or sexual assault, a combat experience, or a natural disaster. Negative emotional reactions and symptoms are common in the days and weeks after a traumatic event. They often go away over time. But, for some people, these reactions persist and do not get better.
- Posttraumatic stress disorder (PTSD) is a mental health condition that can develop after a traumatic or life-threatening event or after exposure to an event happening to someone else. Fear, unwanted memories of the event, avoidance of the reminders of the trauma, and poor sleep may occur following this type of event. A person with PTSD may feel scared, or always be “on guard,” even when no danger is present. These thoughts and feelings can be stressful. They also may interfere with daily activities. Symptoms may last for months or years.
PTSD and SCI
- PTSD is more common in people with SCI than it is in the general population. The lifetime occurrence of PTSD among U.S. adults is 7–9%. Research suggests that PTSD is more prevalent in people with SCI, from 10% up to 60%.
- PTSD can disrupt people’s lives. When left untreated, PTSD may increase the risk of developing physical and mental health problems. It may lead to functional limitations.
Why Are People With SCI at Risk for PTSD?
People with SCI often describe the cause of their SCI as being a traumatic or life-threatening event. Other factors may contribute to the risk of developing PTSD, such as a history of mental health issues before SCI, the severity of the SCI, and chronic pain. Having a strong support system may reduce the risk of developing PTSD.
What Are the Symptoms of PTSD?
PTSD symptoms fall into four categories. A person may have more than one symptom in each category:
- Intrusive memories. A person may have memories, flashbacks, or nightmares that are upsetting. They feel like they are reliving the traumatic event. Reminders of the event also can cause these symptoms. Trauma survivors may feel “triggered” by discussions or depictions of similar traumas, such as in a TV show or movie.
- Avoidance. A person may avoid places, people, and situations that remind them of the traumatic event.
- Negative changes in mood and thinking. A person may have a hard time remembering the traumatic event. They may develop negative beliefs about themselves, others, and their world. They may feel cut off from others and feel low most of the time. A person may also experience fear, horror, anger, guilt, or shame.
- Arousal symptoms. A person may be jumpy, irritable, angered easily, or startle easily. It may be hard to sleep or concentrate.
How Is PTSD Diagnosed?
You can use a short, self- screening questionnaire called the PTSD Self-Screen (https://www.ptsd.va.gov/screen/) to learn if you may have PTSD. A score of 3 or higher indicates that you may have PTSD. However, a clinical interview with a psychologist or other qualified mental health care provider is needed to make a diagnosis. You may be asked how your symptoms affect your life, including work, leisure activities, and relationships. Because some PTSD symptoms such as difficulty sleeping may also be a symptom resulting from SCI, it’s important to find a qualified health care provider with SCI experience who can help determine the cause of your symptoms and provide treatment options.
What Are the Treatment Options for PTSD?
- Prolonged exposure (PE) therapy and cognitive processing therapy (CPT) are evidence-based talk therapies for PTSD. They involve modifying and challenging unhelpful thoughts and emotions related to trauma. They help individuals to confront past memories and face reminders of trauma. These treatments have been shown to be effective for PTSD.
- Other types of treatment that may help include acceptance and commitment therapy, written exposure therapy, eye movement desensitization and reprocessing (EMDR) therapy, and narrative exposure therapy. More research is needed to learn how effective these treatments may be.
- Sometimes medication may be used for treating PTSD, including selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). These medicines work best when used with talk therapy.
Where Can I Find More Information About PTSD?
- Anxiety & Depression Association of America: https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/resources
- National Institute of Mental Health: https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd
- American Psychological Association: https://www.apa.org/topics/ptsd/index
- U.S. Department of Veterans Affairs’ National Center for PTSD: https://www.ptsd.va.gov/
If you have thoughts of suicide or of harming yourself, contact your health care provider or a mental health specialist right away. You can also call or text the Suicide and Crisis Lifeline at 988. You can start a chat at 988lifeline.org to speak to someone now. You can also call 911 or go to your local emergency department if you are in imminent danger of hurting yourself.
References
Krause, J. S., Saunders, L. L., & Newman, S. (2010). Posttraumatic stress disorder and spinal cord injury. Archives of Physical Medicine and Rehabilitation, 91, 1182–1187. https://www.archives-pmr.org/article/S0003-9993(10)00304-7/abstract
Kuiper, H., van Leeuwen, C. C. M., Kopsky, D. J., Stolwijk-Swüste, J. M., & Post, M. W. M. (2021). Post-traumatic stress disorder symptoms and pain intensity in persons with spinal cord injury. Spinal Cord, 59(3), 328–335. https://doi.org/10.1038/s41393-020-00599-w
Li, S., Xue, Y., Li, C., Fan, F., Wei, W., & He, B. (2022). A study on post-traumatic stress disorder and its influencing factors in patients with spinal cord injury. Journal of Clinical and Nursing Research, 6(4), 114–119.
Pollock, K., Dorstyn, D., Butt, L., & Prentice, S. (2017). Posttraumatic stress following spinal cord injury: A systematic review of risk and vulnerability factors. Spinal Cord, 55(9), 800–811. https://doi.org/10.1038/sc.2017.45
Authorship
Posttraumatic Stress Disorder (PTSD) and Spinal Cord Injury was developed by Ann Marie Warren, PhD, Claire Bird, PhD, Megan Douglas, PhD, Mark Powers, PhD, Zina Trost, PhD, Heather B. Taylor, PhD, Susan Robinson-Whelen, PhD, Rosemary Hughes, PhD, Argyrios Stampas, MD, and Allen Heinemann, PhD, in collaboration with the Model Systems Knowledge Translation Center.
Source: The content in this factsheet is based on research and/or professional consensus. This content has been reviewed and approved by experts from the Spinal Cord Injury Model Systems (SCIMS) centers, funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The content of the factsheet has also been reviewed by individuals with SCI and/or their family members.
Disclaimer: This information is not meant to replace the advice of a medical professional. You should consult your health care provider about specific medical concerns or treatment. The contents of this factsheet were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DPKT0009 and 90SIMS0011). Partial funding was provided by the Craig H. Neilsen Foundation through a project titled Promoting the Psychological Health of Persons with Spinal Cord Injury: A Knowledge Translation Project (724833). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this factsheet do not necessarily represent the policy of NIDILRR, ACL, HHS, or the Craig H. Neilsen Foundation and you should not assume endorsement by the federal government.
Recommended citation: Warren, A. M., Bird, C., Douglas, M., Powers, M., Trost, Z., Taylor, H. B., Robinson-Whelen, S., Hughes, R., Stampas, A., & Heinemann, A. (2025). Posttraumatic stress disorder (PTSD) and spinal cord injury. Model Systems Knowledge Translation Center (MSKTC). (https://msktc.org/posttraumatic-stress-disorder-and-spinal-cord-injury)
Copyright © 2025 Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.