, Somatization Disorder, and Substance-Related Disorders (DSM-IV, 1994).
Prevalence of PTSD is stated as ranging from 1 to 14 percent, based on community studies. Studies of at-risk people yield rates ranging from 3 to 58 percent. PTSD may occur at any age. Symptoms usually start within the first three months after the trauma, although they may be delayed for years. Duration of symptoms vary; complete recovery occurs within three months for half of the cases. Severity, duration, and proximity of the exposure to the trauma are considered the most important factors affecting the likelihood of developing PTSD. Social supports, family history, childhood experiences, personality variables, and preexisting mental disorders may influence the development of PTSD (DSM-IV, 1994).
Differential diagnosis includes Adjustment Disorder. In PTSD, the stressor must be extreme, in Adjustment Disorder, the stressor can be any severity. For Acute Stress Disorder, symptoms must occur within 4 weeks of the trauma and resolve within that 4 weeks. Obsessive-Compulsive Disorder includes recurrent intrusive thoughts, but they are experienced as inappropriate and not related to a trauma. Flashbacks in PTSD need to be distinguished from illusions, hallucinations, and other perceptual disturbances (Schizophrenia, etc.). Symptoms of avoidance, numbing, and increased arousal, that were present before the trauma would indicate other diagnosis (DSM-IV, 1994).
Physical symptoms related to PTSD are considered important; they are considered an integral part of the constellation of symptoms that make up PTSD and once examined may reveal additional information about the patient. Physical symptoms may include cardiovascular, respiratory, musculoskeletal, neurological, gastrointestinal, and dermatological symptoms. Physical symptoms may be directly caused by, and therefore reveal the stressor responsible for the resulting PTSD; life-threatening stresso...