Post Traumatic Stress Disorder
What is PTSD?
Post traumatic stress disorder has been recognised as a collection of symptoms for many years, but was only defined about 20 years ago.
Preconditions - Gateway Criteria
The person affected must have been exposed to a definite traumatic event, such as a car accident which involved actual or threatened death or serious injury or a threat to the physical integrity of that person or another, also those who were sexually abused at earlier ages are more likely to develop complex PTSD. Additionally the person's response at the time must have involved fear, helplessness or horror. Unless these gateway criteria are fulfilled a diagnosis of PTSD is not sustained.
Apart from the gateway criteria, other symptons have to be present
The person re-experiences the event in one or more specified ways
recurring, intrusive and distressing recollections or dreams of the event
acting or feeling as if the original event was recurring
intense psychological distress and
psychological reactivity on exposure to cues/reminders of the event (e.g.panic, anxiety)
Persistent avoidance of stimuli associated with the event and numbing of general responsiveness
Efforts to avoid thoughts and/or activities
Inability to recall important aspects of the event
Diminished interest
Feelings of detachment
Restricted range of affect (feelings) and/or a
Sense of foreshortened future
Persistent symptoms of increased arousal
Two or more of the following symptoms
Sleep disturbance
Irritability or anger
Difficulty concentrating
Hypervigilance
Exaggerated startle response
The above three groups of symptoms must have lasted for a month or more and the disturbance has to cause clinically significant distress, impairing social, occupational or other important areas of functioning.
The diagnosis of PTSD is well defined and as valid as other diagnosis, such as a dislocated shoulder or coronary artery disease. It is not lightly made and health professionals should know exactly what is meant when a diagnosis of PTSD has been given to an individual.
Who gets PTSD?
Anyone who has been exposed to a serious traumatic event can get PTSD There are a number of predisposing factors, but these are of limited value in predicting whether particular individuals will develop PTSD. A number of studies have tried to determine the proportion of people involved in road traffic accidents (RTA) who proceed to develop PTSD. Of those who are injured in an RTA, and who seek medical attention, about one in four susequently develop PTSD. About half of those who do develop PTSD. will recover over the first year with no formal treatment. The other half, about one in eight of all involved in RTA's, will have a slower recovery, requiring psychological and medical care.
Treatment for PTSD
In many cases the diagnosis of PTSD is not considered or made or is not thought to be significant. Under these circumstances PTSD is not treated and about half those affected will have prolonged and unnecessary incapacity. Even when the diagnosis of PTSD is made it is not thought readily treated or curable. This belief is in the face of widespread evidence. Psychotropic drugs have a limited but important role in the treatment of PTSD. They are mostly used for treating concomitant depression and/or anxiety. Psychological treatments such as Cognitive Behaviour Therapy (CBT) has proven efficacy. It is, however, of longer duration than EMDR (Eye Movement Desensitation and Reprocessing). Additionally, EMDR is preferred by clients.
Post traumatic stress disorder has been recognised as a collection of symptoms for many years, but was only defined about 20 years ago.
Preconditions - Gateway Criteria
The person affected must have been exposed to a definite traumatic event, such as a car accident which involved actual or threatened death or serious injury or a threat to the physical integrity of that person or another, also those who were sexually abused at earlier ages are more likely to develop complex PTSD. Additionally the person's response at the time must have involved fear, helplessness or horror. Unless these gateway criteria are fulfilled a diagnosis of PTSD is not sustained.
Apart from the gateway criteria, other symptons have to be present
The person re-experiences the event in one or more specified ways
Persistent avoidance of stimuli associated with the event and numbing of general responsiveness
Persistent symptoms of increased arousal
Two or more of the following symptoms
The above three groups of symptoms must have lasted for a month or more and the disturbance has to cause clinically significant distress, impairing social, occupational or other important areas of functioning.
The diagnosis of PTSD is well defined and as valid as other diagnosis, such as a dislocated shoulder or coronary artery disease. It is not lightly made and health professionals should know exactly what is meant when a diagnosis of PTSD has been given to an individual.
Who gets PTSD?
Anyone who has been exposed to a serious traumatic event can get PTSD There are a number of predisposing factors, but these are of limited value in predicting whether particular individuals will develop PTSD. A number of studies have tried to determine the proportion of people involved in road traffic accidents (RTA) who proceed to develop PTSD. Of those who are injured in an RTA, and who seek medical attention, about one in four susequently develop PTSD. About half of those who do develop PTSD. will recover over the first year with no formal treatment. The other half, about one in eight of all involved in RTA's, will have a slower recovery, requiring psychological and medical care.
Treatment for PTSD
In many cases the diagnosis of PTSD is not considered or made or is not thought to be significant. Under these circumstances PTSD is not treated and about half those affected will have prolonged and unnecessary incapacity. Even when the diagnosis of PTSD is made it is not thought readily treated or curable. This belief is in the face of widespread evidence. Psychotropic drugs have a limited but important role in the treatment of PTSD. They are mostly used for treating concomitant depression and/or anxiety. Psychological treatments such as Cognitive Behaviour Therapy (CBT) has proven efficacy. It is, however, of longer duration than EMDR (Eye Movement Desensitation and Reprocessing). Additionally, EMDR is preferred by clients.
