Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) occurs in people who have survived traumatic events that:
1. Have caused death, threatened death, or serious injury to themselves or others; and
2. Have provoked a response involving extreme fear, helplessness, and horror.
Examples of such events include rape or assault, physical injury, military combat, torture, earthquakes, floods, and other traumatic experiences.
The affected person may re-experience the trauma through intrusive and distressing memories, vivid recollections, or nightmares. They may also experience dissociative episodes during which they feel or believe that they are reliving the traumatic event.
The disorder may also involve a form of “psychic numbing” or reduced responsiveness to the surrounding environment, which may manifest as a diminished ability to experience pleasure from everyday activities.
People with PTSD may experience persistent symptoms of increased autonomic arousal, including insomnia, irritability, hypervigilance, difficulty concentrating, and an exaggerated startle response.
Individuals may also become withdrawn and disengage from participation in everyday activities.
Symptoms must persist for more than four weeks to support a diagnosis of PTSD.
Acute Stress Disorder develops in response to traumatic events similar to those associated with PTSD. However, the symptoms begin during or immediately after the traumatic event and last from two days to four weeks.
References:
Kaplan & Sadock: Synopsis of Psychiatry, twelfth edition
Kaplan & Sadock: Pocket Handbook of Clinical Psychiatry, fifth edition;
American Psychiatric Association: Diagnostic Manual of Mental Disorders, 1994;
Robert J. Waldinger: Psychiatry for Medical Students, third edition, translated by Anastas Suli.