Posttraumatic Stress Disorder

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POSTTRAUMATIC STRESS

DISORDER
PTSD

• Symptoms develop after exposure to a traumatic event


• Exposure to actual of threatened death, serious injury or sexual violence in one (or more) of the
following:
• Direct experience traumatic event
• Witnessing, in person, the event occurring to others
• Learning that the event occurred to close family member of friend
• Experiencing repeated or extreme exposure to aversive details of the event.
• One or more Intrusion symptoms associated with the event, after it occurred:
• Recurrent, involuntary and intrusive distressing memories of event
• Recurrent distressing dreams related to the event
• Dissociated reactions (e.g. Flashbacks) as if event were recurring
• Intense or prolonged psychological distress at exposure to internal or external cues symbolic or resembling the
event
• Marked physiological reactions to cues related to event
• Persistent avoidance of stimuli associated with the event
• Distressing memories, thoughts or feelings
• External reminders
• Negative alterations in cognitions and mood associated with event (two or more)
• Inability to remember important aspects of event
• Persistent and exaggerated negative beliefs or expectations about self, others or the world
• Persistent, distorted cognitions about cause or consequences of event
• Persistent negative emotional state
• Markedly diminished interest or participation in significant activities
• Feelings of detachment or estrangement from others
• Persistent inability to experience positive emotions
• Marked alterations in arousal and reactivity associated with event (two or more):
• Irritable behavior and angry outbursts
• Reckless or self- destructive behavior
• Hypervigilance
• Exaggerated startle response
• Problems with concentration
• Sleep disturbance

Duration: more than 1 month


Causes significant distress or impairment
PTSD FOR CHILDREN (6 YEARS OLD –BELOW)

• Similar to PTSD for beyond 6 years except for exposure and developmental expressions of symptoms
• Fear of being separated from parents
• Losing previously- acquired skills
• Sleep problems and nightmares without recognizable content
• Somber, compulsive play in which themes or aspects of the trauma are repeated
• New phobias and anxieties that seem unrelated to the trauma
• Acting out the trauma through play, stories or drawings
• Aches and pain with no apparent cause
• Irritability and aggression
RISK FACTORS

• Pretraumatic Factors
• Temperament (childhood emotional problems, prior mental disorders)
• Environment (low SES, low education, lower intelligence, prior trauma, childhood adversity, cultural
characteristics related to coping)
• Gender (female)
RISK FACTORS

• Peritraumatic Factors
• Severity
• Personal injury
• Interpersonal violence
RISK FACTORS

• Posttraumatic Factors
• Temperament (negative appraisals, inappropriate coping, acute stress disorder)
• Environment (adverse life events, other traumatic losses, social support)
ETIOLOGY
• Psychological
• Related Symptoms prior to trauma
• Inadequate coping strategies
• Temperament
• Biological
• Reactivity and dampening reactivity: Amygdala; Hippocampus; Prefontal Cortex
• Biochemical: Cortisol

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