Posttraumatic Stress Disorder (cont.)
What are the signs and symptoms of PTSD?
The three groups of symptoms that are required to assign the diagnosis of
PTSD are
- recurrent re-experiencing of the trauma (for example, troublesome memories,
flashbacks that are usually caused by reminders of the traumatic events,
recurring nightmares about the trauma and/or dissociative reliving of the
trauma),
- avoidance to the point of having a phobia of places, people, and
experiences that remind the sufferer of the trauma and a general numbing of
emotional responsiveness, and
- chronic physical signs of hyperarousal,
including sleep problems, trouble concentrating, irritability, anger, poor
concentration, blackouts or difficulty remembering things, increased tendency
and reaction to being startled, and hypervigilance to threat.
The emotional numbing of PTSD may present as a lack of interest in activities
that used to be enjoyed (anhedonia), emotional deadness, distancing oneself from
people, and/or a sense of a foreshortened future (for example, not being able to think
about the future or make future plans, not believing one will live much longer).
At least one re-experiencing symptom, three avoidance/numbing symptoms, and two hyperarousal symptoms must be present for at least one month and must cause
significant distress or functional impairment in order for the diagnosis of PTSD
to be assigned. PTSD is considered of chronic duration if it persists for three
months or more.
A similar disorder in terms of symptom repertoire is acute stress disorder.
The major differences between the two disorders are that acute stress disorder
symptoms persist from two days to four weeks, and a fewer number of traumatic
symptoms are required to make the diagnosis as compared to PTSD.
In children, re-experiencing the trauma may occur through repeated play that
has trauma-related themes instead of through memories, and distressing dreams
may have more general content rather than of the traumatic event itself. As in
adults, at least one re-experiencing symptom, three avoidance/numbing symptoms,
and two hyperarousal symptoms must be present for at least one month and must
cause significant distress or functional impairment in order for the diagnosis
of PTSD to be assigned. When symptoms have been present for less than one month,
a diagnosis of acute stress disorder (ASD) can be made.
Symptoms of PTSD that tend to be associated with C-PTSD include: problems
regulating feelings, which can result in suicidal thoughts, explosive anger, or
passive aggressive behaviors; a tendency to forget the trauma or feel detached
from one's life (dissociation) or body (depersonalization); persistent feelings
of helplessness, shame, guilt, or being completely different from others; feeling
the perpetrator of trauma is all-powerful and preoccupation with either revenge
against or allegiance with the perpetrator; and severe change in those things that
give the sufferer meaning, like a loss of spiritual faith or an ongoing sense of
helplessness, hopelessness, or despair.
Next: How is PTSD assessed? »
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