Professional Documents
Culture Documents
Definition
Posttraumatic stress disorder (PTSD) is a condition marked by the development of symptoms after exposure to traumatic life events
Epidemiology
According to the 2005 National Comorbidity Survey-Replication study, PTSD affects about 7.7 million American adults in a given year, though the disorder can develop at any age, including childhood
8% of men and 20% of women go on to develop PTSD 30% of these individuals develop a chronic form that persists throughout their lifetimes.
clinical features
principal clinical features of PTSD are painful reexperiencing of the event a pattern of avoidance and emotional numbing fairly constant hyperarousal
Symptoms of PTSD
intrusions, such as flashbacks or nightmares, avoidance, where the person tries to reduce exposure to people or things that might bring on their intrusive symptoms, hyperarousal,
Symptoms
Recurring nightmares about the event, including possibly intrusive memory flashbacks. Difficulty sleeping or changes in appetite. Feelings of anxiety and fear, especially when exposed to events or situations reminiscent of the trauma.
Symptoms
Edginess, exaggerated startle reflex, or becoming overly alert. Depression, sadness, and lack of energy. Spontaneous crying. Sense of despair and hopelessness. Memory problems, including difficulty in remembering aspects of the trauma.
cont
B. The traumatic event is persistently reexperienced in one (or more) of the following ways: recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children,
repetitive play may occur in which themes or aspects of the trauma are expressed.
intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
cont
C. Persistent
avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following: efforts to avoid thoughts, feelings, or conversations associated with the trauma efforts to avoid activities, places, or people that arouse recollections of the trauma inability to recall an important aspect of the trauma markedly diminished interest or participation in significant activities feeling of detachment or estrangement from others restricted range of affect (e.g., unable to have loving feelings) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
cont
D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following: difficulty falling or staying asleep irritability or outbursts of anger difficulty concentrating hypervigilance exaggerated startle response E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month. F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Hormone Changes
Thyroid function also seems to be enhanced in people with PTSD. Some studies have shown that cortisol levels in those with PTSD are lower than normal Epinephrine and norepinephrine levels are higher than normal.
Treatment
Pharmacotherapy
SSRIs are considered first-line treatments for PTSD
Psychotherapy
behavior therapy cognitive therapy hypnosis
eye movement desensitization and reprocessing (EMDR), in which the patient focuses on the lateral movement of the clinician's finger while maintaining a mental image of the trauma experience. The general belief is that symptoms can be relieved as patients work through the traumatic event while in a state of deep relaxation
A good prognosis is predicted rapid onset of the symptoms short duration of the symptoms (less than 6 months) good premorbid functioning strong social supports the absence of other psychiatric, medical, or substance-related disorders or other risk factors