Posttraumatic Stress Disorder

Author(s):  
Frederick J. Stoddard Jr ◽  
David M. Benedek ◽  
Mohammed R. Milad ◽  
Robert J. Ursano

Posttraumatic stress disorder (PTSD) affects people of all ages and backgrounds and causes persistent suffering and impaired function, but its diagnosis offers the opportunity for early intervention. It is the subject of intensive developmental, epidemiological, genetic/genomic, translational, neurobiological, neuropsychological, and psychological research, and emerging computational methods with “big data,” statistical modeling, and machine learning are likely to accelerate this research. The findings from research on PTSD are changing education and the ways clinicians practice, offering the hope for improved care of those experiencing traumatic stress. Those at particular risk for PTSD include children and adolescents, women, soldiers, refugees and survivors of genocide, sexual orientation minorities, racial and ethnic minorities, patients with burns, injuries and medical trauma, and victims of rape, violence, accidents, and disasters. This chapter provides an overview of PTSD, covering Diagnostic and Statistical Manual of Mental Disorders (fifth edition) diagnostic criteria, epidemiology, neurochemistry and neurobiology, biological and psychological models, assessment, and treatment.

2018 ◽  
Author(s):  
Dana Downs ◽  
Carol North

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may follow exposure to trauma. The experience of trauma has potential personal implications. Some individuals develop PTSD after trauma; others may be more resilient, experiencing distress but not succumbing to psychopathology; and yet others may emerge from the experience with new strength and direction. This review contains 1 figure, 5 tables, and 46 references Keyword: Posttraumatic stress disorder, transcranial magnetic stimulation (TMS), deep brain stimulation, vagal nerve stimulation, transcranial direct current stimulation, Diagnostic and Statistical Manual of Mental Disorders, hypothalamic-pituitary-adrenal (HPA) axis


2018 ◽  
Author(s):  
Dana Downs ◽  
Carol North

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may follow exposure to trauma. The experience of trauma has potential personal implications. Some individuals develop PTSD after trauma; others may be more resilient, experiencing distress but not succumbing to psychopathology; and yet others may emerge from the experience with new strength and direction. This review contains 1 figure, 5 tables, and 46 references Keyword: Posttraumatic stress disorder, transcranial magnetic stimulation (TMS), deep brain stimulation, vagal nerve stimulation, transcranial direct current stimulation, Diagnostic and Statistical Manual of Mental Disorders, hypothalamic-pituitary-adrenal (HPA) axis


CNS Spectrums ◽  
2005 ◽  
Vol 10 (4) ◽  
pp. 311-318 ◽  
Author(s):  
H. Stefan Bracha ◽  
Tyler C. Ralston ◽  
Andrew E. Williams ◽  
Jennifer M. Yamashita ◽  
Adam S. Bracha

AbstractThis review discusses the clenching-grinding spectrum from the neuropsychiatric/neuroevolutionary perspective. In neuropsychiatry, signs of jaw clenching may be a useful objective marker for detecting or substantiating a self-report of current subjective emotional distress. Similarly, accelerated tooth wear may be an objective clinical sign for detecting, or substantiating, long-lasting anxiety. Clenching-grinding behaviors affect at least 8% of the population. We argue that during the early paleolithic environment of evolutionary adaptedness, jaw clenching was an adaptive trait because it rapidly strengthened the masseter and temporalis muscles, enabling a stronger, deeper and therefore more lethal bite in expectation of conflict(warfare)with conspecifics. Similarly, sharper incisors produced by teeth grinding may have served as weaponry during early human combat. We posit that alleles predisposing to fear-induced clenching-grinding were evolutionarily conserved in the human clade (lineage) since they remained adaptive for anatomically and mitochondrially modern humans (Homo sapiens) well into the mid-paleolithic. Clenching-grinding, sleep bruxism, myofacial pain, craniomaxillofacial musculoskeletal pain, temporomandibular disorders, oro-facial pain, and the fibromyalgia/chronic fatigue spectrum disorders are linked. A 2003 Cochrane meta-analysis concluded that dental procedures for the above spectrum disorders are not evidence based. There is a need for early detection of clenching-grinding in anxiety disorder clinics and for research into science-based interventions. Finally, research needs to examine the possible utility of incorporating physical signs intoDiagnostic and Statistical Manual of Mental Disorders, Fifth Editionposttraumatic stress disorder diagnostic criteria. One of the diagnostic criterion that may need to undergo a revision inDiagnostic and Statistical Manual of Mental Disorders, Fifth Editionis Criterion D (persistent fear-circuitry activation not present before the trauma). Grinding-induced incisor wear, and clenching-induced palpable masseter tenderness may be examples of such objective physical signs of persistent fear-circuitry activation (posttraumatic stress disorder Criterion D).


Author(s):  
Gail Theisen-Womersley

AbstractPTSD as a disorder was first introduced as a diagnosis by the American Psychiatric Association (American Psychiatric Association (APA), Diagnostic and statistical manual of mental disorders 1980) in the DSM III in 1980, with interest in it booming to such an extent thereafter that it was referred to in mass media as “the disorder of the 1990s” (Marsella et al., Ethnocultural aspects of posttraumatic stress disorder: Issues, research, and clinical applications, 1996).


2006 ◽  
Vol 19 (1) ◽  
pp. 137-149 ◽  
Author(s):  
Ruth Leys

ArgumentIn 1980, when the diagnosis of Posttraumatic Stress Disorder (PTSD) was introduced into the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III), survivor guilt – a symptom long associated with trauma of the Holocaust and other extreme experiences – was included in the list of symptom criteria. But in the revised edition of the manual of 1987 (DSM-IIIR), survivor guilt was demoted to the status of merely an “associated feature” of the condition. Now that survivor guilt has disappeared from the official lexicon of trauma, shame has come to take its place as the emotion that most defines the traumatic state. This paper examines the rationale for the shift from survivor guilt to shame in the context of the American Psychiatric Association's revisions. It argues that the shift can be understood as yet another manifestation of the oscillation between mimetic and antimimetic theories of trauma that, I have argued in my book Trauma: A Genealogy (2000), has structured the understanding of trauma from the start.


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