Post Traumatic Stress Disorder

by Erika Donaldson

Abstract

Posttraumatic stress disorder (PTSD) begins with exposure to a traumatic event. The disorder is marked by reexperiencing, avoidance of reminiscent stimuli, numbing of responsiveness, and increased arousal associated with the traumatic event. Traumatic events can be experienced directly, witnessed, or learned about. In addition, as with all mental disorders, the symptoms must also cause distress or impairment in areas of functioning to meet the diagnostic criteria. The prevalence of PTSD in adults is 8% over a lifetime (American Psychological Association, 2000). Many psychological, biological, and social factors appear to contribute the development of this disorder (Barlow & Durand, 2009). Other factors, such as the intensity and source (human design vs. nature) of the traumatic effect appear to affect the likelihood of PTSD development (American Psychological Association, 2000). Treatments for PTSD are relatively effective and include cognitive-behavioral therapy, eye movement desensitization and reprocessing (EMDR), and serotonin reuptake inhibitors (SSRIs) (National Center for PTSD, 2008). Special attention for this research review will be given to the experience of PTSD for individuals with developmental disabilities as it relates to the case study.

Diagnostic criteria for 309.81 Posttraumatic Stress Disorder

The person has been exposed to a traumatic event in which both of the following are present:

• the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
• the person’s response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior

The traumatic event is persistently reexperienced in one (or more) of the following ways:

• recurrent and intrusive recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed
• recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable context
• acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur
• intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
• physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
  

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

• efforts to avoid thoughts, feelings, or conversations associated with the trauma
• efforts to avoid actual activities, places, or people that arouse recollections of the trauma
• inability to recall an important aspect of the trauma
• markedly diminished interest or participation in significant activities
• feeling of detachment or estrangement from others
• restricted range of affect (e.g., unable to have loving feelings)
• sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

• difficulty falling or staying asleep
• irritability or outbursts of anger
• difficulty concentrating
• hypervigilance
• exaggerated startle response
  

Duration of disturbance (symptoms in Criteria B, C, and D) is more than 1 month.

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more

Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor.

Related Links

The Center for Trauma Recovery (CTR) www.umsl.edu/divisions/artscience/psychology/ctr/index.html
The National Institute of Mental Health (NIMH)
http://www.nimh.nih.gov/
US Department of Veteran Affairs
http://www.ncptsd.va.gov/