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'''Posttraumatic Post-traumatic stress disorder (PTSD)''' was not recognized as a disease until 1980, when the American Psychiatric Association created a new classification of disease.<ref name="dsm1980">{{REFbook
|last=American Psychiatric Association
|first=
|last=van der Kolk
|first=Bessel
|init=BBA |author-link=Bessel van der Kolk
|year=2014
|title=The Body Keeps the Score
|isbn=978-0-14-312774-1
|accessdate=2021-08-07
}}</ref> Prior to that time, the condition was various variously called ''shell [[shock]]'' or ''combat fatigue''.
The following text is quoted from the [{{WikipediaQuote|URL=https://en.wikipedia.org/wwiki/index.php?Post-traumatic_stress_disorder|title=Posttraumatic_stress_disorder Wikipedia]:Post-traumatic stress disorder}}
<blockquote>
'''Posttraumatic Post-traumatic stress disorder''' ('''PTSD''') may develop after a person is exposed to one or more traumatic events, such as major stress, sexual assault, terrorism, or other threats on a person's life.<ref>American Psychiatric Association (2013). ''Diagnostic and Statistical Manual of Mental Disorders'' (5th ed.). Arlington, VA: American Psychiatric Publishing. pp. 271–280. ISBN 978-0-89042-555-8.</ref> The diagnosis may be given when a group of symptoms, such as disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal, continue for more than a month after the occurrence of a traumatic event.
Most people having experienced a traumatizing event will not develop PTSD.<ref>National Collaborating Centre for Mental Health (UK) (2005). [https://www.ncbi.nlm.nih.gov/books/NBK56494/ "Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care"]. NICE Clinical Guidelines, No. 26. Gaskell (Royal College of Psychiatrists). [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0015848/ Lay summary] – Pubmed Health (plain English).</ref> People who experience assault-based trauma are more likely to develop PTSD, as opposed to people who experience non-assault based trauma such as witnessing trauma, accidents, and fire events.<ref>Zoladz, Phillip (June 2013). "Current status on behavioral and biological markers of PTSD: A search for clarity in a conflicting literature". Neuroscience and Biobehavioral Reviews 37 (5): 860-895. https://dx.doi.org/10.1016%2Fj.neubiorev.2013.03.024</ref> Children are less likely to experience PTSD after trauma than adults, especially if they are under ten years of age. War veterans are commonly at risk for PTSD.
===Child circumcision as a traumatizing event===
When an infant boy is to be [[circumcised]], it is the usual practice to immobilize the infant for the [[Pain| painful]] surgery by securely tying his limbs to a molded plastic board specially made for that purposecalled a [[circumstraint]]. The infant thus is preventing from fighting or fleeing, which is the [[trauma]]-producing situation of ''inescapable [[shock]]'', described as a "''physical condition in which the organism cannot do anything to affect the inevitable''."<ref name="vanderkolk2014B">{{REFbook
|last=van der Kolk
|first=Bessel
|init=BBA |author-link=Bessel van der Kolk
|year=2014
|title=The Body Keeps the Score
}}</ref>
The male [[circumcision]] operation to amputate the [[foreskin]] has been shown to be a traumatic event. Taddio & colleagues (1995)(1997) studied the effect of neonatal circumcision on the behavior of boys after surgery and at the time of vaccination. It was found that [[circumcised ]] boys had a higher pain response at time of vaccination six months later as compared with [[intact ]] boys,<ref name="taddio"1995">{{REFjournal |last=Taddio |first=Anna |init=A |author-link= |last2=Goldbach |first2=Morton |init2=M |author2-link= |last3=Ipp |first3=Moshe |init3=M |author3-link= |last4=Stevens |first4=Bonnie |init4=S |author4-link= |last5=Koren |first5=Gideon |init5=G |author5-link= |TaddioA etal=no |title=Effect of neonatal circumcision on pain responses during vaccination in boys |journal=Lancet |location= |date=1995 |volume=344 |issue= |pages=291-2 |url=http://www.cirp.org/library/pain/taddio/ |archived= |quote= |pubmedID=7837863 |pubmedCID= |DOI=10.1016/s0140-6736(95)90278-3 |accessdate=2020-11-10}}</ref> <ref name="taddio1997">{{REFjournal |last=Taddio |first=Anna |init=A |author-link= |last2=Katz |first2=Joel |init2=J |author2-link= |last3=Ilersich |first3=A. Lane |init3=AL |author3-link= |last4=Gideon |first4=Koren |init4=K |author4-link= |etal=no |title=Effect of neonatal circumcision on pain response during subsequent routine vaccination |journal=Lancet |location= |date=TaddioA KatzJ IlersichAL KorenG 1997-03-01 |volume=342 |issue=9052 |pages=599-603 |url=https://yorkspace.library.yorku.ca/xmlui/bitstream/handle/10315/7941/KAT036.pdf?sequence=1&origin=publication_detail |archived= |quote= |pubmedID=9057731 |pubmedCID= |DOI=10.1016/S0140-6736(96)10316-0 |accessdate=2020-11-28}}</ref> showing that the nervous system had been permanently sensitized to heightened pain sensation.
Taddio et al. (1997) concluded:
<blockquote>
Although postsurgical central sensitisation (allodynia and hyperalgesia) can extend to sites of the body distal from the wound, suggesting a supraspinal effect, the long-term consequences of surgery done without anaesthesia are likely to include post-traumatic stress as well as [[pain]]. It is, therefore, possible that the greater vaccination response in the infants circumcised without anaesthesia may represent an <u>infant analogue of a post-traumatic stress disorder</u> triggered by a traumatic and painful event and re-experienced under similar circumstances of pain during vaccination.<ref name="taddio1997" />
</blockquote>
John Rhinehart, M. D., (1999) a clinical psychiatrist, reported finding numerous cases of [[PTSD ]] in his adult male patients pursuant to infant circumcision.<ref>{{REFjournal
|last=Rhinehart
|first=John
}}</ref>
Boyle & Ramos (2019) studied boys in the Philippine Islands who had undergone medical circumcision and others who had suffered the traditional "''tuli''" circumcision. Of the boys who had a medical circumcision, 51 percent exhibited symptoms of [[PTSD]]. Of the boys who had a ''[[tuli]]'' circumcision, 69 percent exhibited symptoms of PTSD.<ref>{{REFjournal
|last=Boyle
|first=Gregory J.
{{SEEALSO}}
* [[Adverse Childhood Experiences (ACEs)]]* [[TuliCircumstraint]]
* [[Pain]]
* [[Psychological issues of male circumcision]]
* [[Psychiatrist Discusses the Lasting Trauma of Circumcision]]
* [[Trauma]]
* [[Tuli]]
{{LINKS}}
* {{REFweb
|url=https://www.betterhealth.vic.gov.au/health/HealthyLiving/trauma-and-children-newborns-to-two-years
{{REF}}
[[Category:Circumcision risk]]
[[Category:Pain]]
[[Category:Psychology]]
[[Category:Trauma]]
[[de:Posttraumatische Belastungsstörung]]