Post traumatic stress disorder history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
History
Traumatic experiences
- Childhood physical, emotional, or sexual abuse, including prolonged or extreme neglect; also witnessing such abuse inflicted on another child or an adult
- Experiences and interactions that are experienced as psychological "attacks"; for example a continual perception of psychological force, invalidation or annihilation.
- Experiencing (including witnessing) an event perceived as life-threatening, such as:
- a serious accident
- medical complications or serious illness such as cancer
- violent physical assault or witnessing such an event, including torture
- adult experiences of sexual assault
- warfare, policing and other occupations exposed to violence or disaster
- violent, life threatening, natural (or man made) disasters
- incarceration
Symptoms
Symptoms of PTSD fall into three main categories:
- Reliving the event, which disturbs day-to-day activity
- Flashback episodes, where the event seems to be happening again and again
- Repeated upsetting memories of the event
- Repeated nightmares of the event
- Strong, uncomfortable reactions to situations that remind you of the event
- Avoidance
- Emotional "numbing," or feeling as though you don't care about anything
- Feeling detached
- Being unable to remember important aspects of the trauma
- Having a lack of interest in normal activities
- Showing less of your moods
- Avoiding places, people, or thoughts that remind you of the event
- Feeling like you have no future
- Arousal
- Difficulty concentrating
- Startling easily
- Having an exaggerated response to things that startle you
- Feeling more aware (hypervigilance)
- Feeling irritable or having outbursts of anger
- Having trouble falling or staying asleep
- You might feel guilt about the event (including survivor guilt). You might also have some of the following symptoms, which are typical of anxiety, stress, and tension:
Diagnostic criteria
The diagnostic criteria for PTSD, per the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as:
- A. Exposure to a traumatic event
- B. Persistent reexperience
- C. Persistent avoidance of stimuli associated with the trauma
- D. Persistent symptoms of increased arousal (e.g. difficulty falling or staying asleep or hypervigilance)
- E. Duration of symptoms more than 1 month
- F. Significant impairment in social, occupational, or other important areas of functioning
Notably, criterion A (the "stressor") consists of two parts, both of which must apply for a diagnosis of PTSD. The first (A1) requires that "the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others." The second (A2) requires that "the person’s response involved intense fear, helplessness, or horror." The DSM-IV-TR criterion differs substantially from the previous DSM-III-R stressor criterion, which specified the traumatic event should be of a type that would cause "significant symptoms of distress in almost anyone," and that the event was "outside the range of usual human experience." Since the introduction of DSM-IV, the number of possible PTSD traumas has increased and one study suggests that the increase is around 50%.[1]