Posttraumatic Stress Disorder

September 23, 2011

Posttraumatic stress disorder (PTSD) is an anxiety disorder that follows exposure to a traumatic event. Research shows that 10.4% of women and 5.0% of men develop Posttraumatic stress disorder at some point in their lives. The precise reason for the twice greater prevalence of Posttraumatic stress disorder in women is not known, though a combination of biological causes (e.g., hormones) and environmental causes (e.g., gender socialization) are most likely responsible.

A traumatic event is the experiencing or witnessing of actual or threatened death or serious injury. In women the most frequent traumas are childhood sexual abuse, rape, domestic violence, and traumatic labor and delivery.

The symptoms of Posttraumatic stress disorder are divided into three categories. The first is the persistent reexperiencing of the traumatic event. This reexperiencing can take the form of intrusive recollections, recurrent dreams, reliving of the experience, hallucinations, flashbacks, and intense psychological distress and/or anxiety on exposure to cues that symbolize the traumatic event.

The second category of symptoms is avoidance of stimuli associated with the trauma and numbing of responsiveness. The avoidance can take the form of efforts to avoid thoughts, feelings, activities, places, or people associated with the trauma. The avoidance can also be manifested by the inability to recall important aspects of the trauma. The numbing can take the form of diminished interest in significant activities, a feeling of detachment or estrangement from other people, restricted range of feelings and emotions (e.g., love or intimacy), and a sense of a foreshortened future.

The third category of symptoms are those of increased arousal. Profound difficulty falling or staying asleep is a hallmark of Posttraumatic stress disorder. Other symptoms of increased arousal are irritability or outbursts of anger, hypervigilance, exaggerated startle response, and difficulty concentrating.

The majority of individuals who experience a trauma manifest some of the above symptoms, but in approximately 50-66% of cases the symptoms begin to improve within 4 weeks. If the significant symptoms persist after 1 month, then a diagnosis of Posttraumatic stress disorder can be made.

Individuals with chronic Posttraumatic stress disorder commonly develop additional psychiatric illnesses. Depression and alcohol and/or substance abuse are the most common comorbid illnesses, but there is also an increased prevalence of panic disorder, generalized anxiety disorder, obsessivecompulsive disorder, and mania. The occurrence of the aforementioned comorbid illnesses can complicate the course and treatment of Posttraumatic stress disorder.

Psychotherapy and medication are the two major forms of treatment of Posttraumatic stress disorder. The most commonly used psychotherapeutic treatments are known as cognitivebehavioral interventions. The goals of these techniques include: (a) helping patients to confront traumatic memories rather than avoid them; (b) decreasing avoidance of normal activities; (c) reducing anxiety associated with traumatic memories; and (d) correcting beliefs that have decreased self-esteem or the ability to function (e.g., inordinate guilt or feelings of helplessness).

The second major form of treatment of Posttraumatic stress disorder is medication. The group of medications that is known as antidepressants actually improves Posttraumatic stress disorder whether depression is present or not. The most effective medications in this category are the selective serotonin reuptake inhibitors, that is, medications that increase the availability of the neurotransmitter serotonin in the brain.

Future research on Posttraumatic stress disorder is focused on understanding how trauma adversely effects the biological functioning of the brain as a means of refining the treatment of the disorder. Recent research on an area of the brain known as the amygdala promises to enhance the understanding of how traumatic memories are recorded and reexperienced. Such research could lead to improved treatment of Posttraumatic stress disorder and could perhaps lead to prevention of the disorder in those exposed to traumatic events.

SEE ALSO: Anxiety disorders, Depression, Mood disorders, Panic attack

Suggested Reading

  • Foa, E. B., Keane, T. M., & Friedman, M. J. (Eds.). (2000). Effective treatments for PTSD. New York: Guilford Press.
  • Miller, L. J., & Wiegartz, P. (2002). Posttraumatic stress disorder: How to meet women’s specific needs. Current Psychiatry, 2(2), 25-26, 35-38.
  • Yehuda, R. (Ed.). (1998). Psychological trauma. Washington, DC: American Psychiatric Press.

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