Disorder (PTSD) is a debilitating condition that follows a terrifying
event. Often, people with PTSD have persistent frightening thoughts
and memories of their ordeal and feel emotionally numb, especially with
people they were once close to. PTSD, once referred to as shell shock,
was first brought to public attention by war veterans, but it can result
from any number of traumatic incidents. These include kidnapping, serious
accidents such as car or train wrecks, natural disasters such as floods
or earthquakes, violent attacks such as a mugging, rape, or torture,
or being held captive. The event that triggers it may be something that
threatened the person's life or the life of someone close to him or
The person has experienced or witnessed or was confronted with an unusually
traumatic event that has both of these elements:
The event involved
actual or threatened death or serious physical injury to the person
or to others,
The person felt intense fear, horror or helplessness
The person repeatedly relives the event in at least 1 of these ways:
recollections - thoughts, images.
Repeated, distressing dreams.
Through flashbacks, hallucinations or illusions, acts or feels as
if the event were
Marked mental distress in reaction to internal or external cues that
resemble the event.
Physiological reactivity - such as rapid heart beat, elevated blood
pressure in response to these cues.
The person repeatedly avoids the trauma-related stimuli and has numbing
of general responsiveness (absent before the traumatic event) as shown
by 3 or more of:
Tries to avoid
thoughts, feelings or conversations concerned with the event.
Tries to avoid activities, people or places that recall the event.
Cannot recall an important feature of the event.
Marked loss of interest or participation in activities important to
Feels detached or isolated from other people.
Restriction in ability to love or feel other strong emotions.
Feels life will be brief or unfulfilled (lack of marriage, job, children).
At least 2 of the following symptoms of hyperarousal were not present
before the traumatic event:
Increased startle response
The above symptoms have lasted longer than one month.
These symptoms cause clinically important distress or impair work, social
or personal functioning.
The most common
precipitating events for PTSD in women were rape and physical assault
(33.8% and 32.3% of reported events, respectively).
For men, seeing
someone seriously hurt or killed and physical assault were the most
prevalent (25.3% and 20.3%). Women and men were equally likely to
have been exposed to trauma.
were more likely than men to meet criteria for lifetime and current
gender differences, subjects who were severely dependent on cocaine
more likely than moderately dependent subjects to meet lifetime criteria
PTSD also was
more prevalent in subjects with a history of major depression, antisocial
personality disorder, and cannabis dependence, but not alcohol dependence.
or Sexual Dysfunction
Guilt or Obsession
Some disorders display similar or sometimes even the same symptom. The
clinician, therefore, in his/her diagnostic attempt, has to differentiate
against the following disorders which he/she needs to rule out to establish
a precise diagnosis.
Brief Psychotic Disorder.
Major Depressive Disorder.
Acute Stress Disorder
Mood Disorder With Psychotic
Psychotic Disorders Due to a General Medical Condition
can occur at any age as it is dependent upon the experience of a traumatic
event. Such events include:
Violent Criminal Attacks
Life threatening natural disasters
The cause is not
known, but psychological, genetic, physical, and social factors may
contribute to it. In studies of Vietnam war veterans, those with strong
support systems were less likely to develop PTSD than those without
or poor support systems and PTSD develops
immediately after they experience the traumatic event. However, in other
people, signs of the disorder do not develop until several weeks, months,
or even years after the event.