Posttraumatic Stress Disorder

Author(s):  
Vladan Starcevic, MD, PhD

Posttraumatic stress disorder (PTSD) develops in predisposed individuals who have had a traumatic experience. There are many different ways in which PTSD presents itself, and only some of them(e.g., avoidance behavior, symptoms of hyperarousal)make it look like other anxiety disorders. Various manifestations of PTSD have led to its also being considered primarily a disorder of memory, a dissociative disorder, or a condition more closely related to depression. Given the presumed etiological link between a traumatic event and PTSD, there is a rare opportunity among psychiatric disorders for implementation of strategies that might prevent the development of PTSD. Most people recover after trauma, while many of those who do develop PTSD remit spontaneously. Still, a proportion of traumatized people develop a chronic form of PTSD–a condition that is often very difficult to treat. Posttraumatic stress disorder has been a controversial entity since its official introduction in the psychiatric classification in 1980.Anumber of issues have arisen, and many of them remain unresolved. Some of the key questions are listed below…. 1. Is the concept of PTSD too heterogeneous? 2. Are there different types of PTSD or different disorders arising in the aftermath of trauma? 3. Has the concept of a traumatic event become too broad? Alternatively, can a greater variety of stressful events precipitate PTSD? 4. Is the occurrence of trauma necessary for the development of PTSD? 5. Are there any specific or unique features of PTSD, which would allow its differentiation from related disorders? 6. Has the concept of PTSD been overused or misused, especially in the context of compensation claims and litigation? Does PTSD reflect a ‘‘medicalization’’ of the normal human reactions and emotions in response to trauma? 7. What accounts for the fact that the majority of trauma victims recover spontaneously from early PTSD-like symptoms, whereas some go on to develop a chronic, severe, and debilitating PTSD? Has there been too much emphasis on vulnerability to developing post-trauma psychopathology and too little attention paid to factors such as resilience? 8. Why do we still have a difficulty understanding what combination of risk factors best predicts the development of PTSD?

CNS Spectrums ◽  
1998 ◽  
Vol 3 (S2) ◽  
pp. 22-29 ◽  
Author(s):  
Rachel Yehuda

In 1980, the diagnosis of posttraumatic stress disorder (PTSD) was established to recognize that exposure to events such as rape, physical assault, torture, or combat can leave long-lasting psychological scars in persons who undergo these experiences. The intention of the diagnosis was to acknowledge that exposure to a traumatic event was a sufficient explanation for the occurrence of longterm psychological problems. Prior to this formulation, stressful events were thought to precipitate symptoms that would resolve over time. The symptoms manifested by persons following adverse events were characterized as transient adjustment reactions. Longerterm symptoms were considered to be a reflection of underlying neurosis, rather than stress exposure per se.The diagnosis of PTSD provided a paradigm for acknowledging that exposure to devastating trauma can produce symptoms that can be quite severe and chronic in nature. Although many of the symptoms of PTSD were similar to those that occur in other anxiety or mood disorders, the hallmark of PTSD appeared to be a preoccupation with the traumatic event and a resultant set of behavioral changes that occurred because of attempts to avoid reminders of the event.


2016 ◽  
Vol 4 (3) ◽  
pp. 453-454 ◽  
Author(s):  
Slavica Arsova ◽  
Nensi Manusheva ◽  
Gabriela Kopacheva-Barsova ◽  
Stojan Bajraktarov

BACKGROUND: World statistical data show that a large number of individuals suffer from posttraumatic stress disorder (PTSD) after exposure to the intense traumatic event. PTSD can have a chronic course with enduring changes in the functioning of the person.CASE PRESENTATION: Here we report two adult individuals of different gender and education who were exposed to the extremely severe stressful event after which difficulties in psychological functioning developed. The first case we present is a 46-year-old man, with completed high education, divorced, father of two children, who lives with his parents, and is retired. Disorders appeared 20 years ago when he was exposed to extremely severe stressful events in war circumstances that included captivity, torture, and loss of fellow soldiers. The second case is a 50-year-old female patient, with a university degree, professor of art, married, and mother of two children of whom the son died six years ago. She suffered from disorders after the sudden injury of her son that ended with his death.CONCLUSION: Posttraumatic stress disorder after the intense stress is a risk of development enduring personality changes with serious individual and social consequences. 


CNS Spectrums ◽  
2006 ◽  
Vol 11 (2) ◽  
pp. 106-117 ◽  
Author(s):  
Eyal Shemesh ◽  
Margaret L. Stuber

AbstractCan a medical illness or its treatment qualify as an emotionally traumatic event and can it cause posttraumatic stress disorder symptoms? If so, can the view of a medical illness as a traumatic experience enhance our ability to understand patients' adjustment to illness and their emotional reactions to it? Is it important to identify posttraumatic symptoms and try to address them in medically ill patients? These questions form the backbone for this review. Because many questions remain unanswered (or the answers are not definitive yet), we concisely summarize the issues and present our own view of the most pressing questions for further research.


2006 ◽  
Vol 22 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Eelco Olde ◽  
Rolf J. Kleber ◽  
Onno van der Hart ◽  
Victor J.M. Pop

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.


Journalism ◽  
2017 ◽  
Vol 19 (9-10) ◽  
pp. 1308-1325 ◽  
Author(s):  
Mina Lee ◽  
Eun Hye Ha ◽  
Jung Kun Pae

This study investigated posttraumatic stress disorder (PTSD) symptoms on Korean journalists and the contributing variables. Predicting variables included the exposure to traumatic events, coping strategy, social support, optimism, negative beliefs, and the journalists’ occupational perspectives. A total of 367 Korean journalists participated in the survey. The findings revealed that, first, Korean journalists had suffered severely from PTSD symptoms according to the prevalence rate. Second, the extent of traumatic event exposure, the length of career, the use of dysfunctional coping strategy, a lack of social support, and negative beliefs were identified as significantly related variables. Finally, occupational perspectives showed meaningful associations with development of the symptoms. This study provided an empirical analysis of Korean journalists’ experiences of traumatic events and psychological stress for the first time.


2009 ◽  
Vol 105 (3) ◽  
pp. 889-899 ◽  
Author(s):  
Stefan Bogaerts ◽  
Maarten J. J. Kunst ◽  
Frans W. Winkel

This study examined Posttraumatic Stress Disorder in relation to secure and insecure attachment styles based on data collected in a sample of 81 Belgian security workers. All had experienced one traumatic event in the previous year. The sample was divided into a securely attached and an insecurely attached group. The three PTSD symptom scales, Re-experiencing, Avoidance, and Hyperarousal, differentiated significantly between the two attachment groups; the dismissive attachment style was negatively related to PTSD. Individuals with a positive view of themselves and a negative view of others have less risk of developing PTSD than those with a fearful or preoccupied attachment style. A relationship between the dismissive attachment style with grandiose narcissism seems possible. Interest has been expressed in medical approaches; therefore, the importance of medical research on PTSD is emphasized.


Assessment ◽  
1996 ◽  
Vol 3 (1) ◽  
pp. 17-25 ◽  
Author(s):  
Dean Lauterbach ◽  
Scott Vrana

This paper describes three studies of the reliability and validity of a newly revised version of the Purdue Posttraumatic Stress Disorder scale (PPTSD-R). The PPTSD-R is a 17-item questionnaire that yields four scores: Reexperiencing, Avoidance, Arousal, and Total. It is highly internally consistent (α = .91), and the scores are relatively stable across time. The PPTSD-R is highly correlated with other measures of PTSD symptomatology and moderately correlated with measures of related psychopathology, providing preliminary support for the measure's convergent and discriminant validity. It reliably distinguishes between groups of people who were and were not traumatized, it is sensitive to the impact of different types of traumatic events, and (within a clinical sample) it discriminates between those who did and did not seek treatment for difficulty coping with the traumatic event being assessed. The PPTSD-R shows promise as a measure of PTSD symptoms in the college population.


Author(s):  
Joel Paris

Posttraumatic stress disorder (PTSD) differs from other categories that are underdoing diagnostic epidemics, in that its treatment is primarily based on psychotherapy. PTSD tends to be overdiagnosed when clinicians attribute, rightly or wrongly, symptoms to a traumatic event. Yet most people who undergo trauma do not develop PTSD, and people without trauma can have similar symptoms. This chapter shows how the construct of PTSD arose historically. A problematic DSM definition, in relation both to the nature of stressors and the links between stress and outcome, causes PTSD to be overdiagnosed. The result is that many patients are receiving the wrong kind of psychotherapy for their problems.


2018 ◽  
Vol 10 (3) ◽  
pp. 33
Author(s):  
Anderson Diaz Perez ◽  
Elvis Eliana Pinto Aragón ◽  
Carmenza Leonor Mendoza Cataño ◽  
Moraima del Toro Rubio ◽  
Elkin Navarro-Quiroz

INTRODUCTION: Posttraumatic Stress Disorder (PTSD) is a psychiatric syndrome known since 1980 with multiple names in the military field. Its etiology is multicausal, whose predominant factor is the lack of adaptation and managing with events considered traumatic. Objective. To describe the clinical characteristics such as the type of psychological and pharmacological treatment received by the naval military with diagnosis of Posttraumatic Stress Disorder at the Psychiatric Unit of Cartagena’s Naval Hospital.METHODOLOGY: A descriptive, retrospective cross-sectional study with an associative approach (Crosstabulation). The sample was 242 navy subjects with PTSD diagnosis. The information was collected with a data collection form of medical records. The information analysis was developed through the program SPSS ® 21.0. Chi2 and value of p≤0.05 calculation was applied through the crossing of variables.RESULTS: The most prevalent type of traumatic event was the one represented by combat with the presence of depressive disorders and anxiety with a value of p≤0.05.CONCLUSIONS: The PTSD severity is related to the severity of the event, in addition if the trumatic event was repetitive.


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