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Posttraumatic Stress Disorder. Overview of Symptoms and Treatment L. Gordon Brewer, Jr., M.Ed., LMFT. Defining PTSD. The Diagnostic and Statistical Manual of Mental Disorders categorizes 12 different types of anxiety disorders.

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posttraumatic stress disorder

Posttraumatic Stress Disorder

Overview of Symptoms and Treatment

L. Gordon Brewer, Jr., M.Ed., LMFT

defining ptsd
Defining PTSD
  • The Diagnostic and Statistical Manual of Mental Disorders categorizes 12 different types of anxiety disorders.
  • PTSD falls in the subtype of anxiety disorders called stress disorders.
  • Stress disorders are symptomatic reactions to traumatic events in a person’s life.
  • PTSD is found in both adults and children.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd defined
PTSD Defined
  • Posttraumatic Stress Disorderis the development of characteristic symptoms following exposure to an extreme traumatic stressor .
  • It usually involves direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity.
  • It can involve witnessing an event that involves death, injury, or a threat to the physical integrity of another person.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd defined4
PTSD Defined
  • It can involve learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate.
  • The person's response to the event involves intense fear, helplessness, or horror (or in children, the response involves disorganized or agitated behavior)

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd defined5
PTSD Defined
  • The characteristic symptoms resulting from the exposure to the extreme trauma include:
    • Persistent re-experiencing of the traumatic event
    • Persistent avoidance of stimuli associated with the trauma
    • Numbing of general responsiveness
    • Persistent symptoms of increased arousal.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd defined6
PTSD Defined
  • Traumatic events that are experienced directly include, but are not limited to:
    • Military combat
    • Violent personal assault (sexual assault, physical attack, robbery, mugging)
    • Being kidnapped or being taken hostage
    • Terrorist attack
    • Torture
    • Incarceration as a prisoner of war or in a concentration camp
    • Natural or manmade disasters,
    • Severe automobile accidents
    • Being diagnosed with a life-threatening illness.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd defined7
PTSD Defined
  • For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury.
  • Witnessed events include, but are not limited to:
    • Observing the serious injury or unnatural death of another person due to violent assault
    • Accident
    • War
    • Disaster
    • Unexpectedly witnessing a dead body or body parts.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd defined8
PTSD Defined
  • Events experienced by others that are learned about include, but are not limited to:
    • Violent personal assault
    • Serious accident
    • Serious injury experienced by a family member or a close friend
    • Learning about the sudden, unexpected death of a family member or a close friend
    • Learning that one's child has a life-threatening disease.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd defined9
PTSD Defined
  • The disorder may be especially severe or long lasting when the stressor is of human design (e.g., torture, rape). The likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd manifestations
PTSD Manifestations
  • Commonly the person has recurrent and intrusive recollections of the event or recurrent distressing dreams during which the event is replayed.
  • In some instances, the person experiences dissociative states (loose touch with reality) that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd manifestations11
PTSD Manifestations
  • A person will experience intense psychological distress or physiological reactivity that often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event.
  • Examples of these would be: anniversaries of the traumatic event; hearing a gun shot or loud noise for combat veterans; entering any elevator for a woman who was raped in an elevator.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd manifestations12
PTSD Manifestations
  • For these people anything associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event and to avoid activities, situations, or people who arouse recollections of it.
  • This avoidance of reminders may include amnesia for an important aspect of the traumatic event.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd manifestations13
PTSD Manifestations
  • The person may experience a diminished responsiveness to the external world, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event.
  • The individual may complain of having markedly diminished interest or participation in previously enjoyed activities, of feeling detached or estranged from other people, or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness, and sexuality).

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd manifestations14
PTSD Manifestations
  • The individual may have a sense of a foreshortened future; For example, not expecting to have a career, marriage, children, or a normal life span.
  • The individual will have persistent symptoms of anxiety or increased arousal that were not present before the trauma.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

ptsd manifestations15
PTSD Manifestations
  • The symptoms may include difficulty falling or staying asleep that may be due to recurrent nightmares during which the traumatic event is relived, hypervigilance, and exaggerated startle responses.
  • Some individuals report irritability or outbursts of anger or difficulty concentrating or completing tasks.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

in a nut shell
In a Nut Shell…
  • The symptoms of PTSD are characterized by the victim of a traumatic event emotionally and psychological re-living the events when they are triggered by anything that reminds them of the traumatic event.
  • The symptoms are pervasive and intrusive not only on a personal level, but to their families and loved ones.

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

in a nut shell17
In a Nut Shell…
  • There three clusters of symptoms:
    • Re-experiencing symptoms (“flashbacks”, nightmares, upsetting thoughts and memories, etc.)
    • Avoidance symptoms (distancing from others, avoiding thoughts and feelings about the event, etc.)
    • Hyperarousal symptoms (difficulty sleeping, feeling “jumpy”, anger outbursts, aggression, etc.)

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

in a nut shell18
In a Nut Shell…
  • A person might have any number of the symptoms associated with PTSD; not necessarily all of them.
  • However, to be diagnosed with PTSD, a person would need to have certain number of symptoms from each cluster.
  • Severity of symptoms can vary according to many different factors (e.g.. Supports available, general temperament, other life stressors, etc.)

Diagnostic & Statistical Manual of Mental Disorders, 4th Edition

treatment of ptsd
Treatment of PTSD
  • Left untreated, PTSD can lead to any number of more severe symptoms and manifestations:
      • Increased risk for suicide
      • Risk of alcohol and drug abuse or addiction
      • Risk of legal involvement
      • Domestic violence
      • Family dysfunction
treatment of ptsd20
Treatment of PTSD
  • Effective Treatments:
    • Trauma Focused Cognitive Behavioral Therapy
    • Exposure Therapy
    • Medications - Selective serotonin reuptake inhibitors (SSRIs)
    • Group therapy
    • Family therapy
    • EMDR (Eye movement desensitization and reprocessing)
    • Brief psychodynamic psychotherapy

Source: National Center for PTSD

resources
Resources
  • National Center for PTSD

http://www.ncptsd.va.gov/

  • National Institute for Mental Health

http://www.nimh.nih.gov/

  • Anxiety Disorders Association of America

http://www.adaa.org

  • Sidran Institute – Traumatic Stress Advocacy

http://www.sidran.org/

  • American Association of Marriage and Family Therapists

http://www.aamft.org

  • National Child Traumatic Stress Network

http://nctsnet.org

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