scholarly journals The uniqueness of the DSM definition of post-traumatic stress disorder: implications for research

2002 ◽  
Vol 32 (4) ◽  
pp. 573-576 ◽  
Author(s):  
N. BRESLAU ◽  
G. A. CHASE ◽  
J. C. ANTHONY
Keyword(s):  
Major Depression ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Sleep Problems ◽  
Traumatic Event ◽  
Post Traumatic Stress ◽  
Specific Syndrome ◽  
Post Traumatic ◽  
Definition Of

The official definition of post-traumatic stress disorder (PTSD) in DSM-III and is subsequent DSM editions is based on a conceptual model that brackets traumatic or catastrophic events from less severe stressors and links them with a specific syndrome. The diagnosis of PTSD requires an identifiable stressor and the content of the defining symptoms refers to the stressor, for example, re-experiencing the stressor and avoidance of stimuli that symbolize the stressor. Temporal ordering is also required: when sleep problems and other symptoms of hyperarousal are part of the clinical picture, they must not have been present before the stressor occurred. The ICD-10 definition of PTSD follows the same model. The defining symptoms alone, without a connection to the stressor, are not regarded as PTSD (Green et al. 1995). Since the introduction of PTSD in DSM-III, the official definition has been adopted in most studies, although discussions about the validity of the definition has continued (Breslau & Davis, 1987; Davidson & Foa, 1993; Green et al. 1995). Although it is widely believed that other disorders (e.g. major depression) can be precipitated by external events, these disorders can occur independent of stressors and do not require a link with a traumatic event in their diagnostic criteria. Previous classifications that separated major depression into stress-related (reactive) or endogenous have been abandoned in newer versions of the DSM, because of lack of evidence of the validity of this distinction.

Child trauma

2012 ◽  
pp. 1728-1731
Author(s):  
David Trickey ◽  
Dora Black
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Traumatic Events ◽  
Post Traumatic Stress ◽  
Attachment Problems ◽  
Repeated Events ◽  
Post Traumatic ◽  
Definition Of

This chapter will focus on the impact on children of traumatic events other than child abuse or neglect, which are covered in Chapter 9.3.3. According to the DSM-IV-TR definition of post-traumatic stress disorder (PTSD), traumatic events involve exposure to actual or threatened death or injury, or a threat to physical integrity. The child's response generally involves an intense reaction of fear, horror, or helplessness which may be exhibited through disorganized or agitated behaviour. Terr suggested separating traumatic events into type I traumas which are single sudden events and type II traumas which are long-standing or repeated events. If the traumatic event includes bereavement, the reactions may be complicated and readers should consult Chapter 9.3.7 to address the bereavement aspects of the event. Following a traumatic event, children may react in a variety of ways (see Chapters 4.6.1 and 4.6.2 for the adult perspective on reactions to stressful and traumatic events). Many show some of the symptoms of post-traumatic stress disorder—re-experiencing the event (e.g. through nightmares, flashbacks, intrusive thoughts, re-enactment, or repetitive play of the event), avoidance and numbing (e.g. avoidance of conversations, thoughts, people, places, and activities associated with the traumatic event, inability to remember a part of the event, withdrawal from previously enjoyed activities, feeling different from others, restriction of emotions, sense of foreshortened future), and physiological arousal (e.g. sleep disturbance, irritability, concentration problems, being excessively alert to further danger, and being more jumpy). In young children the nightmares may become general nightmares rather than trauma-specific. Other reactions to trauma in children are: ♦ becoming tearful and upset or depressed ♦ becoming clingy to carers or having separation anxiety ♦ becoming quiet and withdrawn ♦ becoming aggressive ♦ feeling guilty ♦ acquiring low self-esteem ♦ deliberately self-harming ♦ acquiring eating problems ♦ feeling as if they knew it was going to happen ♦ developing sleep disturbances such as night-terrors or sleepwalking ♦ dissociating or appearing ‘spaced out’ ♦ losing previously acquired developmental abilities or regression ♦ developing physical symptoms such as stomach aches and headaches ♦ acquiring difficulties remembering new information ♦ developing attachment problems ♦ acquiring new fears ♦ developing problems with alcohol or drugs. Such problems may individually or in combination cause substantial difficulties at school and at home. The reactions of some children will diminish over time; however, for some they will persist, causing distress or impairment, warranting diagnosis, and/or intervention. Research predicting which children will be more likely to be distressed following a traumatic event suffers from a number of methodological flaws. However, factors which are often identified as constituting a risk for developing PTSD across a number of studies include: level of exposure, perceived level of threat and peri-traumatic fear, previous psychological problems, family difficulties, co-morbid diagnoses, subsequent life events, and lack of social support.

Support for the mutual maintenance of pain and post-traumatic stress disorder symptoms

2009 ◽  
Vol 40 (7) ◽  
pp. 1215-1223 ◽  
Author(s):  
A. Liedl ◽  
M. O'Donnell ◽  
M. Creamer ◽  
D. Silove ◽  
A. McFarlane ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Structural Equation ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Saturated Model ◽  
Post Traumatic Stress ◽  
Post Injury ◽  
Post Traumatic ◽  
The Relationship

BackgroundPain and post-traumatic stress disorder (PTSD) are frequently co-morbid in the aftermath of a traumatic event. Although several models attempt to explain the relationship between these two disorders, the mechanisms underlying the relationship remain unclear. The aim of this study was to investigate the relationship between each PTSD symptom cluster and pain over the course of post-traumatic adjustment.MethodIn a longitudinal study, injury patients (n=824) were assessed within 1 week post-injury, and then at 3 and 12 months. Pain was measured using a 100-mm Visual Analogue Scale (VAS). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS). Structural equation modelling (SEM) was used to identify causal relationships between pain and PTSD.ResultsIn a saturated model we found that the relationship between acute pain and 12-month pain was mediated by arousal symptoms at 3 months. We also found that the relationship between baseline arousal and re-experiencing symptoms, and later 12-month arousal and re-experiencing symptoms, was mediated by 3-month pain levels. The final model showed a good fit [χ2=16.97, df=12, p>0.05, Comparative Fit Index (CFI)=0.999, root mean square error of approximation (RMSEA)=0.022].ConclusionsThese findings provide evidence of mutual maintenance between pain and PTSD.

scholarly journals Prevalence of Post Traumatic Stress Disorder among School-age Adolescent

2020 ◽  
pp. 40-49
Author(s):  
Khalid Astitene ◽  
Hassan Aguenaou ◽  
Laila Lahlou ◽  
Amina Barkat
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Demographic Data ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Reaction Index ◽  
High Prevalence ◽  
Post Traumatic

Aim: After a traumatic event, the person can develop post-traumatic stress disorder (PTSD), the purpose of the study is to assess the prevalence of PTSD in adolescents in public middle schools of the prefecture of Salé in Morocco and study anxiety and depression which are the comorbid disorders of the PTSD. The survey was carried out from March to June 2017. Methods: 523 students were selected by the cross-sectional method from fifteen schools that were randomly selected, the age of the students vary between 12 and 17 years. For the survey, standardized questionnaires (the socio-demographic data, the Life Events Checklist, the CPTS-RI (Children's Post Traumatic Stress Reaction Index), the STAIY (State Trait Inventory Anxiety Form Y) and the CDI (Children Depression Inventory) were used which were filled in by the students. Results: The prevalence of PTSD was 70.4% in the students who have PTSD. We found that the prevalence in boys was 46.74%, while in girls it was 53.26%. In addition to that, 81% of students found to be anxious and 51.8% of students have depression. Conclusion: There is a high prevalence of post traumatic stress disorder among adolescents, there are practical implications for the support and care of these adolescents.

Clinicians after the suicide of their patients

2021 ◽  
pp. 549-554
Author(s):  
Onja T. Grad
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Past Experiences ◽  
Suicidal Patients

Emotional turmoil, disruption, shock, post-traumatic stress disorder (PTSD), doubts in own competences as a professional: these are only few of many feelings and reactions that clinicians might experience when faced with the fact that patients they had treated took their lives. The range of reactions can span from none, which is rare, to severe disorders, and can sometimes result in more precautious treatment of future patients, or even in leaving the field of working with suicidal patients. How clinicians respond depends on many factors, such as the length and intensity of the treatment, the understanding of patients’ suicide, the knowledge and past experiences the clinicians have as well as the response of the patients’ family, and the response and support of the colleagues and the institution in which the treatment took place. Some of these factors can help—while others can hinder—the process of overcoming the traumatic event of patients’ suicide.

scholarly journals The spectral fingerprint of sleep problems in post-traumatic stress disorder

SLEEP ◽  
2019 ◽  
Vol 43 (4) ◽  
Author(s):  
M de Boer ◽  
M J Nijdam ◽  
R A Jongedijk ◽  
K A Bangel ◽  
M Olff ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Rem Sleep ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Sleep Problems ◽  
Nrem Sleep ◽  
Post Traumatic Stress ◽  
Oscillation Power ◽  
Post Traumatic

Abstract Study Objectives Sleep problems are a core feature of post-traumatic stress disorder (PTSD). The aim of this study was to find a robust objective measure for the sleep disturbance in patients having PTSD. Methods The current study assessed EEG power across a wide frequency range and multiple scalp locations, in matched trauma-exposed individuals with and without PTSD, during rapid eye movement (REM) and non-REM (NREM) sleep. In addition, a full polysomnographical evaluation was performed, including sleep staging and assessment of respiratory function, limb movements, and heart rate. The occurrence of sleep disorders was also assessed. Results In patients having PTSD, NREM sleep shows a substantial loss of slow oscillation power and increased higher frequency activity compared with controls. The change is most pronounced over right-frontal sensors and correlates with insomnia. PTSD REM sleep shows a large power shift in the opposite direction, with increased slow oscillation power over occipital areas, which is strongly related to nightmare activity and to a lesser extent with insomnia. These pronounced spectral changes occur in the context of severe subjective sleep problems, increased occurrence of various sleep disorders and modest changes in sleep macrostructure. Conclusions This is the first study to show pronounced changes in EEG spectral topologies during both NREM and REM sleep in PTSD. Importantly, the observed power changes reflect the hallmarks of PTSD sleep problems: insomnia and nightmares and may thus be specific for PTSD. A spectral index derived from these data distinguishes patients from controls with high effect size, bearing promise as a candidate biomarker.

scholarly journals Psychological sequelae of political imprisonment, specifically post-traumatic stress disorder, in 491 Days by Winnie Madikizela-Mandela

Literator ◽  
2018 ◽  
Vol 39 (1) ◽  
Author(s):  
Marisa Botha
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Traumatic Experiences ◽  
Post Traumatic Stress ◽  
Psychological Sequelae ◽  
Main Cluster ◽  
Post Traumatic ◽  
Political Imprisonment

This article analyses well-known anti-apartheid activist Winnie Madikizela-Mandela’s prison memoir 491 Days: Prisoner Number 1323/69 (2013) for depictions of suffering. This memoir reveals aspects of politically inflicted trauma, particularly the suffering sustained in prolonged solitary confinement and the resulting psychological sequelae for the prisoner. To move beyond a vague understanding of her traumatic experiences, this article draws on the field of psychiatry, specifically the diagnostic criteria for post-traumatic stress disorder (PTSD) to gain greater insight as this tool may also be regarded as a type of narrative that could aid in the comprehension of traumatic events. References will be made to the three main cluster symptoms of PTSD: involuntary re-experiencing of the traumatic event, avoidance of reminders and an ongoing sense of threat. An interdisciplinary literary-psychological approach will probably lead to a deeper understanding of the mental consequences of political imprisonment, as PTSD was not an acknowledged disorder during Madikizela-Mandela’s detainment.

Usability Assessment of a Post-Traumatic Stress Disorder (PTSD) mHealth App

2017 ◽  
Vol 61 (1) ◽  
pp. 1824-1828 ◽  
Author(s):  
Carolina Rodriguez-Paras ◽  
Farzan Sasangohar
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Treatment Options ◽  
Mental Health Disorder ◽  
Assessment Tools ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Color Scheme

Post-traumatic stress disorder (PTSD) is a common mental health disorder that can affect those who have experienced a traumatic event. Despite the availability of different treatment options for PTSD, there are several barriers that prevent some patients from receiving treatment. To overcome these barriers, mobile health (mHealth) apps have been developed to allow access to therapeutic and self-assessment tools outside the clinic. Our review of literature shows that the three mostly used apps (PTSD Coach, PE Coach, and CPT Coach) are not empirically evaluated and very little information is available for the process used in design and development of these tools. This paper documents a usability study of the most popular PTSD mHealth app; PTSD Coach. Findings indicate that the learning component of the app provides useful information, the assessment is effective in keeping track of the symptoms, and that some of the tools provided can help mitigate some of the symptoms. However, the color scheme, lack of personalization options, and lack of clarity on the mitigation techniques was deemed to affect usability.

POSTTRAUMATIC GROWTH IN A PROCESS OF REHABILITATAION

2018 ◽  
pp. 57-63 ◽  
Author(s):  
O. Tokhtamysh
Keyword(s):  
Posttraumatic Growth ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Psychological Trauma ◽  
Post Traumatic Stress ◽  
Rehabilitation Process ◽  
Post Traumatic Growth ◽  
Post Traumatic

This topic is particularly relevant in the context of combat operations in eastern Ukraine against the occupation of the country, where members of the combined forces operation in each day are in a situation threatening the life and risk of getting a military psychological trauma. The article considers the elements and conditions of post-traumatic growth in the context of the rehabilitation process and the social promotion of human development after a traumatic event. The phenomenon of post-traumatic growth can transform the concept of rehabilitation into a term that can be labeled as "proabilitation". The forms of social and rehabilitation support in terms of creating conditions for post-traumatic growth and their effectiveness are explored. The theoretical and applied models with resource elements of the rehabilitation process and post-traumatic growth process are analyzed. It is noted that the traditional model of posttraumatic growth pay attention to the process of rumination and getting control over it and ignores one of the basic symptom of posttraumatic stress disorder, such as uncontrolled visual images (flash backs). The two-component concept of post-traumatic growth, which may be «illusory» or «adaptive», can also be presented as a «compensatory» or «healing» type with regard to the presence or absence of post-traumatic stress disorder symptoms after reaching post-traumatic growth. Posttraumatic growth occurs in several domains and can be depending on the type of traumatic event experienced, the individual reactions and the psychological qualities of the person. This process is not such that it automatically eliminates the symptoms of post-traumatic stress disorder, the same, rejecting the need for psychotherapeutic and psychosocial care and focusing only on post-traumatic growth can be a false strategy for those who have experienced a traumatic event. Consequently, the phenomenon of post-traumatic growth can be regarded as a powerful resource factor for the rehabilitation process, in particular, as a motivational component of psychosocial assistance.

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