Apr. 17th 2019 Advice / information

What is post-traumatic stress disorder?

Post-traumatic stress disorder is characterized by the development of specific symptoms following exposure to a traumatic event in a context of death, death threats, serious injury, or threat to life or physical integrity. Exposure to the event may be direct or indirect (e.g., witness or learn that a loved one has been exposed).

The symptoms of Post Traumatic Stress Disorder fall into four categories:

  • A tendency to relive the event (e.g., invasive, involuntary, spontaneous, and recurrent memories of the traumatic event, nightmares)
  • A tendency to avoid (e.g., avoidance of thoughts, feelings, places or persons that cause recall of the traumatic event)
  • Cognitive and emotional alterations (e.g., persistent blame, negative perception of self, others, or the world)
  • Hyper-arousal (e.g., exaggerated startled reactions, hypervigilance)

These symptoms must persist for more than one month after the event and cause suffering or impaired functioning.

Need more information about post-traumatic stress disorder?

The DSM-5 (American Psychological Association, 2013)1 provides 8 criteria for diagnosing Post Traumatic Stress Disorder:

Criterion A: Exposure to actual death or threat of death, serious injury or sexual violence.

Criterion B: Invasive symptoms associated with the event (reliving the trauma)

  • Repetitive, involuntary, and pervasive remembering of the event generating distress
  • Repetitive dreams causing a sense of distress in connection with the event
  • Dissociative reactions (e.g., flashbacks)
  • Severe and prolonged feelings of distress when exposed to internal or external cues that evoke or resemble the event
  • Physiological reactions when exposed to internal or external cues that evoke or resemble the event

Criterion C: Persistent avoidance of stimuli associated with the event

  • Avoidance of memories, thoughts, or feelings related to the event
  • Avoidance of external stimuli (people, places, conversations) that elicit memories of the event

Criterion D: Negative alterations in cognition and mood associated with the event

  • Inability to remember an important aspect of the event
  • Negative and exaggerated beliefs or expectations (of themselves, others, or the world)
  • Persistent cognitive distortions about the cause or consequences of the event that cause the subject to blame or blame others
  • Persistent negative emotional state
  • Net reduction of interest in important activities or reduction of participation
  • Feelings of emotional detachment or remoteness
  • Persistent inability to feel positive emotions

Criterion E: Significant alterations in the level of arousal and responsiveness associated with the event

  • Irritability, tantrums, verbal / physical aggression
  • Unwise / self-destructive behaviors
  • Hypervigilance
  • Exaggerated startled response
  • Concentration problems
  • Sleep problems

Criterion F: The disturbance lasts more than a month

Criterion G: The disturbance is not attributable to the physiological effects of a substance or another medical condition.

In children under 6, the criteria for diagnosing post-traumatic stress disorder vary from those in adults (see DSM-5, American Psychological Association, 2013)

Following a traumatic event, Post Traumatic Stress Disorder rarely occurs alone. Thus, 60-75% of people with Post Traumatic Stress Disorder have associated disorders that need to be considered in the treatment plan (Kessler, Sonnega, Bromet, Hughes & Nelson, 1995)3. The most common comorbid symptomatologies include depression (48% of Post Traumatic Stress Disorder victims, Kessler et al., 1995)4 with increased suicidal risk, substance abuse (alcohol abuse in 52% of men and 28% of women, drug abuse in 35% of men and 27% of women, Kessler et al., 1995)5, and anxiety disorders (generalized anxiety in 17%, panic attack in 7%, Kessler et al., 1995)6.

 

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