Absolute worst

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Possible Answers: PITS.

Random information on the term “PITS”:

Perpetration-Induced Traumatic Stress (abbreviated PITS), also known as Participation-Induced Traumatic Stress, occurs when the symptoms of Posttraumatic Stress Disorder (PTSD) are caused by an act or acts of killing or similar horrific violence.

The DSM-5 addresses the idea of active participation as a cause of trauma under the discussion accompanying its definition of PTSD, and adds to the list of causal factors: “for military personnel, being a perpetrator, witnessing atrocities, or killing the enemy.”

There has been some study with combat veterans, people who carry out executions or torture, police who shoot in the line of duty, people who commit criminal homicide, abortion staff, and others. Much of the study was previous to the official definition of PTSD, and symptoms have shown up in personal stories throughout history, and in the keen observations of the writers of great literature, most notably Macbeth by William Shakespeare.

Indications from all studies that have considered the question of severity have indicated that symptoms tend to be more severe for those who have killed than for other causes of traumatization. One study using the U.S. government data base of American veterans of Vietnam has suggested that the pattern of symptoms at least in combat veterans may be different in those who said they had killed as opposed to those who said they had not, with intrusive imagery (dreams, flashbacks, unwanted thoughts) being more prominent along with the explosive outbursts of anger, and concentration and memory problems being less prominent. To a lesser extent, hypervigilance, a sense of alienation, and the non-PTSD symptom of a sense of disintegration were also found greater as a matter of pattern for those who answered yes on killing. Additionally, alcohol and cocaine abuse appeared to be more severe.

PITS on Wikipedia

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