Maxine Spalding 57708754 PYC4802 03/11/2022
Question 1:
Post traumatic stress disorder is diagnosed in adults, adolescents and children over
the age of 6 according to the following characteristics in the DSM-5.
Criterion A, states that the individual needs to be exposed to a threat or be actively
involved in an incident such as sexual violence, injury or death. This exposure can be
directly or witnessed by the individual. The individual may learn of an event which a
loved one may have been involved in. This may be violent or accidental. An individual
may be also repeatedly exposed to details of events or death such as a first responder
on scene of an accident, collecting the remains of an accident and so on. This excludes
the exposure to events on television and social media.
After the event, the individual needs to present one (or more) of the following
characteristics. The individual must have constant, reoccurring and intrusive
memories. Children may show this in repeated play. The individual has nightmares
relating to the traumatic event. In children, these nightmares may be present without
them realizing. An individual may have flashbacks which may be brief or cause
complete blackouts. Children may reenact this during play. The individual may also
have psychological distress and reactions to symbols which resemble the trauma and
lastly, the individual may have extreme psychological reactions to similar events or
circumstances. This is criterion B.
According to criterion C, the individual may also avoid things which are similar to the
trauma such as distressing memories, thoughts and feelings and external reminders
such as people and places. According to the DSM-5, one or both of these are
acceptable for diagnosing.
After the traumatic event, the individual may battle to recall key details which is not
due to head injury or drugs. They may also have persistent and often thoughts and
exaggerate things such as the world is dangerous. The individual may also begin to
self-blame or blame others for the event. Linked to this, they may also have consistent
negative emotions such as guilt, fear and shame but also battle to express positive
emotions and moods. They may also have no interest in activities which were
previously important. An individual may feel alienated and detached from others. Two
of these are required for a diagnosis. This is criterion D.
1
, Maxine Spalding 57708754 PYC4802 03/11/2022
Criterion E, states that two or more alterations in reactions to trauma related events
are required. These are irritable and aggressive behaviour, hypervigilance, an
exaggerated startle response, inability to concentrate and sleep disturbance.
The above symptoms (Criterion B, C, D and E) need to be present for more than one
month.
The individual may have difficulty or distress in social, occupational, and other areas
of functioning.
These symptoms may not be linked to other reasons such as drug use, head injury,
alcohol consumption or brief psychotic disorders.
The individual must also have high levels of one of the following in order to meet a full
diagnosis. These are depersonalization which is the feeling of being outside ones body
and therefore not attached. Or, the individual must feel a sense of derealization which
is the expression that things are not real or not as they seem.
A full diagnosis is not met until 6 months after the event, however in some cases,
symptoms do develop immediately.
There are several factors which may influence diagnosing PTSD. This first is the
nature of the event as there is no single relationship between events and PTSD.
Simply put, people react differently to certain things. One must however consider that
those who have suffered physical injury will have a greater risk of developing PTSD.
Secondly, as mentioned previously, individuals react differently and therefore have a
different onset of symptoms.
The delayed onset of symptoms also poses a challenge when assessing someone.
Symptoms can take up to 6 months in order to show, thus pinpointing an exact event
for some may be difficult.
There may also be cultural differences defined by socio-cultural factors. This may
cause a different interpretation such as anxiety not being accepted by the Indian
culture. This is also linked to the DSM-5 being primarily Eurocentric and therefore not
always compatible for our African cultures. For example, conversion, physical
disorders and psychosis will all be incorrectly diagnosed.
2