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~ Post-Traumatic Stress Disorder ~

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Facts about Post-Traumatic Stress Disorder:

Posttraumatic Stress Disorder, or PTSD, is a psychiatric disorder that can occur following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape. People who suffer from PTSD often relive the experience through nightmares and flashbacks, have difficulty sleeping, and feel detached or estranged, and these symptoms can be severe enough and last long enough to significantly impair the person's daily life.

National Center for PTSD / VA
http://www.ncptsd.va.gov/facts/general/fs_what_is_ptsd.html

What Are the Symptoms of PTSD?

Many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger symptoms. People with PTSD also experience emotional numbness and sleep disturbances, depression, anxiety, and irritability or outbursts of anger. Feelings of intense guilt are also common. Most people with PTSD try to avoid any reminders or thoughts of the ordeal. PTSD is diagnosed when symptoms last more than 1 month.

NIMH National Institute of Mental health http://www.nimh.nih.gov/publicat/ptsdfacts.cfm

DSM IV criteria for 309.81 Posttraumatic Stress Disorder:

A. The person has been exposed to a traumatic event in which both of the following have been present:

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others

(2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

(1) 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.

(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.

(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

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:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma

(2) efforts to avoid activities, places, or people that arouse recollections of the trauma

(3) inability to recall an important aspect of the trauma

(4) markedly diminished interest or participation in significant activities

(5) feeling of detachment or estrangement from others

(6) restricted range of affect (e.g., unable to have loving feelings)

(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

(1) difficulty falling or staying asleep

(2) irritability or outbursts of anger

(3) difficulty concentrating

(4) hypervigilance

(5) exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more

Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor

What is Complex PTSD?

Prolonged, extreme traumatic circumstances such as childhood sexual abuse, prisoner of war camps, or long-term domestic violence can cause a form of PTSD called Complex PTSD. As in PTSD, ordinary, healthy persons under severe circumstances can experience changes in how they adapt to stress and how they view themselves. A mental health diagnosis called Borderline Personality Disorder is also highly indicative of a history of trauma, and is increasingly viewed as a type of Complex PTSD.

Possible symptoms of Complex PTSD are:

bullet severe behavioral difficulties (such as alcohol/drug abuse, aggression, eating disorders)
bullet difficulty in controlling intense emotions (such as anger, panic, or depression)
bullet other mental difficulties (such as amnesia or dissociation a serious condition called Dissociative Identity Disorder, formerly known as Multiple Personality Disorder, which is characterized by "splitting off" parts of oneself).

http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm

Therapeutic Approaches Commonly Used to Treat PTSD:

Cognitive-behavioral therapy (CBT) involves working with cognitions to change emotions, thoughts, and behaviors. Exposure therapy is one form of CBT that is unique to trauma treatment. It uses careful, repeated, detailed imagining of the trauma (exposure) in a safe, controlled context to help the survivor face and gain control of the fear and distress that was overwhelming during the trauma. In some cases, trauma memories or reminders can be confronted all at once ("flooding"). For other individuals or traumas, it is preferable to work up to the most severe trauma gradually by using relaxation techniques and by starting with less upsetting life stresses or by taking the trauma one piece at a time ("desensitization").

Along with exposure, CBT for trauma includes:

bullet learning skills for coping with anxiety (such as breathing retraining or biofeedback) and negative thoughts ("cognitive restructuring"),
bullet managing anger,
bullet preparing for stress reactions ("stress inoculation"),
bullet handling future trauma symptoms,
bullet addressing urges to use alcohol or drugs when trauma symptoms occur ("relapse prevention"), and
bullet communicating and relating effectively with people (social skills or marital therapy).

National Center for PTSD / VA
http://www.ncptsd.va.gov/facts/treatment/fs_treatment.html

 

Links:

American Psychiatric Association
An easy to read informative page on Posttraumatic Stress Disorder.

http://www.psych.org/public_info/ptsd.cfm

Complex PTSD - Fact Sheet
Differences between the effects of short-term trauma and the effects of chronic trauma.
http://www.ncptsd.va.gov/facts/specific/fs_complex_ptsd.html

The Posttraumatic Stress Disorder (PTSD) Alliance
Is a group of professional and advocacy organizations that have joined forces to provide educational resources to individuals diagnosed with PTSD and their loved ones; those at risk for developing PTSD; and medical, healthcare and other frontline professionals.
http://www.ptsdalliance.org/

Trauma Information Pages
These Trauma Pages focus primarily on emotional trauma and traumatic stress, including PTSD (Post-traumatic Stress Disorder) and dissociation, whether following individual traumatic experience(s) or a large-scale disaster.
http://www.trauma-pages.com/

 

 

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