Posttraumatic Stress Disorder (PTSD) is characterized by the symptoms that follow an extreme trauma. Diagnostic features, associated features, prevalence, course, differential diagnosis, and treatment considerations are discussed.
Posttraumatic Stress Disorder (PTSD) involves symptoms that follow exposure to an extreme traumatic stressor. The response to the event needs to involve intense fear, helplessness, or horror, persistent reexperiencing of the trauma, and persistent symptoms of increased arousal. These symptoms must occur for more than one month and the distress must result in distress or impairment in social, occupational, or other functioning. Stimuli associated with the trauma are avoided, this may include thoughts, feelings, conversations, activities, situations, people or any reminders; this avoidance may also include amnesia for aspects of the trauma. Emotional numbing or diminished responsiveness to the external world may begin soon after the trauma. Feelings of detachment and loss of interest may occur. The future may feel foreshortened. Anxiety symptoms were not present prior to the trauma and may include sleep disturbances with nightmares, hypervigilance, exaggerated startle response, outbursts of anger, and difficulty concentrating (DSM-IV, 1994).
PTSD is diagnostically classified as 309.81 with specifiers of acute, chronic, or delayed onset. Associated feelings include guilt for surviving. Associated symptoms include self-destructive and impulsive behavior, dissociative symptoms, somatic complaints, feelings of ineffectiveness, shame, despair, hopelessness, feeling damaged, a loss of beliefs, hostility, social withdrawal, feeling threatened, impaired relationships, or a change from previous personality characteristics. There may be an increased risk for other disorders to include: Panic Disorder, Agoraphobia, Obsessive-Compulsive Disorder, Social Phobia, Specific Phobia, Major Depressive Disorder...