In this comprehensive collection, we explored the intricate aspects of PTSD, including its causes, symptoms, and treatment options. We gained insight into the psychological and physiological effects of traumatic events on individuals. We delved into the diagnostic criteria and assessment methods fo...
PSYC 300
Chapter 9 – Post Traumatic Stress Disorder
9.4 Post-Traumatic Stress Disorder (p. 268 – 277)
- Post-traumatic stress disorder (PTSD): an anxiety disorder in which a particularly stressful event
(e.g., military combat, rape, natural disaster) brings in its aftermath intrusive re-experiencing of
the trauma, a numbing of responsiveness to the outside world, estrangement from others, a
tendency to be easily startled, nightmares, recurrent dreams, and disturbed sleep.
Entails an extreme response to a severe stressor, including increased anxiety, avoidance
of stimuli associated with the trauma, and a numbing of emotional responses.
Description, Symptoms, and Prevalence
- PTSD is defined by a cluster of symptoms.
- Unlike the definitions of other psychological disorders, the definition of PTSD includes part of its
presumed etiology a traumatic event
- Definition of PTSD was changed considerably in DSM-5.
In previous versions, the event was supposed to have created intense fear, horror, or
helplessness.
It is now recognized that people can be variable in their emotional reactions,
- Significant change across versions of the DSM is what type of event is considered a trauma-
inducing event.
Previous editions of DSM said traumatic event was defined as “outside the range of
human experience.” traumatic event could be a life-threatening natural disaster
Examining outside the range of human experience was considered too restrictive
would rule out PTSD following automobile accidents, death of a loved one, or prolonged
exposure to abuse.
Some consider the current definition too restrictive it focuses on event's objective
characteristics rather than subjective meaning
- DSM-5 now specifies an event might have happened to the victim and witnesses.
A person can experience trauma if it occurs to a family member or close friend rather
than themself event only applies if it involved violence or an accident.
- Previous PTSD diagnostic criteria included 17 symptoms
- Current criteria involve 20 symptoms across four symptom categories
Some symptoms remain but have wording changes in how they are described.
Fourth general category has been newly added looks at negative alterations in
cognitions and moods associated with the traumatic event.
- Other symptoms for PTSD are grouped into three major categories diagnosis requires
symptoms last longer than one month.
1. Intrusion symptoms associated with the traumatic event.
Intrusions come in various forms including distressing or memories.
Individual frequently recalls the event and experiences nightmares about it.
Intense emotional upset is produced by stimuli that symbolize the event
o E.g., thunder reminding a veteran of the battlefield
o E.g., anniversaries of some specific experience (e.g., death date)
2. Persistent avoidance of stimuli associated with the event beginning after the event has
occurred
Person tries to avoid thinking about trauma or encountering stimuli that will bring it
to mind.
3. Marked alterations in arousal and reactivity associated with the traumatic event.
Symptoms include irritable behaviour, reckless or self-destructive behaviour,
insomnia, difficulty concentrating, hypervigilance, and an exaggerated startle
response.
, Lab studies have confirmed clinical symptoms by documenting heightened
physiological reactivity of PTSD participants to combat imagery and high-
magnitude startle responses
- More extreme trauma tends to have more impact in terms of the number of disorders and
associated levels of dysfunction (e.g., 911)
- There is a difference between PTSD and acute stress disorder
Everyone experiences stress to a considerable degree.
Acute Stress Disorder Diagnoses if the stressor causes significant impairment in
social or occupational functioning that lasts for at least three days and less than one
month
o Proportion of people who develop acute stress disorder varies with the type of
trauma they experience.
o Following rape, the figure is extremely high (over 90%)
o Other traumas, e.g., mass shooting, motor vehicle accident have low figures,
(around 13% for motor accident victims)
o Although some get over acute stress disorder, many develop PTSD
- Prevalence of PTSD varies depending on how people are assessed.
- Lifetime prevalence of PTSD in Canada is almost 1 in 10 & one-month prevalence is about 1 in
25
Prevalence varies depending on the severity of the trauma experienced
o About 3% among civilians exposed to a physical attack
o About 20% among people wounded in Vietnam War (war in general)
o About 50% among rape victims and people POWs (prisoners of war)
- Factors deemed to increase PTSD symptoms include community silence, limited help-seeking
(stigma of seeking help), and insufficient proactive provision of therapeutic resources
Etiology of Post-Traumatic Stress Disorder
- Research and theory on causes of PTSD focus on risk factors for the disorder, as well as
psychological and biological factors.
Risk Factors
- Important to consider not only the risk factors for PTSD, but the likelihood of being exposed to
trauma.
- Research indicates males have higher levels of trauma exposure across various event types,
except for child sexual abuse and sexual assaults, yet females have higher levels of PTSD
- Several risk factors for PTSD.
Exposure to a traumatic event
Predictors of PTSD
Gender
Perceived threat to life
Early separation from parents
Family history of a disorder
Previous exposure to traumas
o Previous exposure to trauma is regarded as one of the strongest predictors of
whether the individual is exposed subsequently to trauma
Pre-existing disorders (an anxiety disorder or depression)
- PTSD hyperarousal symptoms are uniquely predictive of traumatic stressors.
Different types of PTSD symptoms play different roles in subsequent exposure to
different types of events.
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