mood swings, anger outbursts, temper tantrums) and post-traumatic stress symptoms, independent of age, gender, or type of trauma.Moral injury the feeling of moral distress such as a shame or guilt following a moral transgression is associated with PTSD but is distinguished from it. Moral injury is associated with shame and guilt while PTSD is associated with anxiety and fear. : 2,8,11

Risk factors
Persons considered at risk include combat military personnel, survivors of natural disasters, concentration camp survivors, and survivors of violent crime. Persons employed in occupations that expose them to violence (such as soldiers) or disasters (such as emergency service workers) are also at risk. Other occupations that are at higher risk include police officers, firefighters, ambulance personnel, health care professionals, train drivers, divers, journalists, and sailors, in addition to people who work at banks, post offices or in stores. Trauma
PTSD has been associated with a wide range of traumatic events. The risk of developing PTSD after a traumatic event varies by trauma type and is highest following exposure to sexual violence (11.4%), particularly rape (19.0%). Men are more likely to experience a traumatic event (of any type), but women are more likely to experience the kind of high-impact traumatic event that can lead to PTSD, such as interpersonal violence and sexual assault.Motor vehicle collision survivors, both children and adults, are at an increased risk of PTSD. Globally, about 2.6% of adults are diagnosed with PTSD following a non-life-threatening traffic accident, and a similar proportion of children develop PTSD.
Bufotoxins are a family of toxic steroid lactones or substituted Tryptamines of which some may or may not be toxic. They occur in the parotoid glands, skin and poison of many toads (genus Bufo) and other amphibians, and in some plants and mushrooms. The exact composition varies greatly with the specific source of the toxin. It can contain 5-MeO-DMT, bufagins, bufalin, bufotalin, bufotenin, bufothionine, dehydrobufotenine, epinephrine, norepinephrine, and serotonin. Some authors have also used the term bufotoxin  to describe the conjugate of a bufagin with suberylarginine.The toxic substances found in toads can be divided by chemical structure in two groups:

bufadienolides, which are cardiac glycosides (e.g., bufotalin, bufogenin)
tryptamine-related substances (e.g., bufotenin)Toads known to secrete bufotoxin include the following:
Bufo alvarius
Bufo americanus
Bufo arenarum
Bufo asper
Bufo blombergi
Bufo boreas
Bufo bufo
Bufo bufo gargarizans
Sclerophrys gutturalis (syn. Bufo gutturalis)
Bufo formosus
Bufo fowleri
Rhinella marina (formerly Bufo marinus)
Bufo melanostictus
Bufo peltocephalus
Bufo quercicus
Bufo regularis
Bufo valliceps
Bufo viridis
Bufo vulgaris

Extraction
Extract from the skin of certain Asian toads, such as Bufo bufo gargarizans and Bufo melanostictus, is often found in certain Chinese folk remedies. The Pharmacopoeia of the Peoples Republic of China (ChP) considers the two species valid sources of toad venom (Chinese: 蟾酥; pinyin: Chánsū; Latin: bufonis venenum), and requires the dry product to contain at least 6% of cinobufagin and resibufogenin combined by weight. The extract is obtained by squeezing the parotoid glands of caught, washed toads for a white venom and drying; the final dried venom is usually brown, with a chunk or flake form. Human poisoning
Toad‐venom poisoning is rare but can kill.