WHAT IS IT?
As defined by the National Institute of Mental Health,
PTSD
PTSD is a prolonged reaction to experiencing or
witnessing a traumatic event (natural disaster, violent
act, bad accident, etc) that interferes with aspects of
daily life. This can mean trouble sleeping and
POST-TRAUMATIC concentrating, feelings of intense stress or fear, or
STRESS DISORDER feelings of social isolation. Though many people may
experience feelings of sadness, anxiousness, or anger
after witnessing a traumatic event, those diagnosed
with PTSD experience these symptoms and others for
an extended period of time.
THE HISTORY OF PTSD
The earliest history of Post-Traumatic symptoms centers
mainly on soldiers being traumatized by war, though slavery,
disease, and physical, domestic, and sexual abuse were also
common historical causes. In war (civil war, WWI, WWII), it
was called shell-shock, soldier’s heart, and war neurosis, to
name a few. It was also called “Post-Traumatic Neurosis” in
Britain as early as the 1700s. “Gross Stress Reaction” was
included in the first edition of the Diagnostic and Statistic
Manual of Mental Disorders. It described that it develops
from “severe physical demands” or “extreme emotional
stress resulting from either combat or civilian catastrophe.”
The first time “Post-Traumatic Stress Disorder” was
recognized as a diagnosis was in 1980, in the DSM-III. The
criteria include the existence of a recognizable stressor,
reexperiencing of the trauma (dreams, recollections,
sensations), numbing of responsiveness to the external
world, and at least two symptoms not present before the
trauma (6 are listed involving sleep, behavior, memory, etc).
It also lists two subtypes of PTSD, Acute PTSD and Chronic/
Delayed PTSD. The DSM-IV introduced Acute Stress
Disorder, a Post-Traumatic Disorder with symptoms lasting
up to 4 weeks. The descriptions, symptoms, and causes were
also updated to be much more detailed, though they kept
the main ideas of the original criteria. The most recent DSM,
DSM-V, introduced a Dissociative Subtype for PTSD.
SYMPTOMS AND DIAGNOSTIC CRITERIA
This is the current criteria for PTSD as listed by the DSM-V (summarized):
A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the
following ways:
Directly experiencing the traumatic event
Witnessing, in person, the event(s) happening to others
Learning that the it happened to a close family member or friend
Experiencing repeated/extreme exposure to details of the traumatic event(s) (e.g., first
responders, police officers)
B. One or more of the intrusion symptoms:
Recurrent, involuntary & intrusive distressing memories of the event(s)
Dissociative reactions (e.g. flashbacks)
Psychological distress at cues that resemble an aspect of the event(s)
C. Persistent avoidance of stimuli (memories, thoughts, people, places, etc.)
D. Negative alterations in cognitions and mood
Negative beliefs about oneself, others, or the world
Diminished interest/participation
Feelings of detachment/estrangement
Persistent negative state (e.g. fear, horror, anger, guilt)
E. Arousal and reactivity associated with the event(s)
Irritable behavior and angry outbursts
Reckless or self-destructive behavior
Hypervigilance and exaggerated startle response
Problems with concentration and sleep disturbances
F. Criteria B, C, D, and E last more than 1 month
G. The disturbance causes clinically significant distress/impairment in areas of functioning
H. The disturbance is not due to the effects of a substance or other medical condition
IMPACT
PTSD symptoms can affect family members and friends along
with those who have been diagnosed. It may be harder to
communicate and get along. Stress can overwhelm both
parties. If someone who is diagnosed has children, they may
have trouble communicating their symptoms to their children,
and their children may have a hard time understanding them.
For example, a parent trying to avoid reminders of the event
may cause their child to feel like lonely or ignored, and act out
to get attention. Negative moods caused by the disorder may
also rub off on the children or make them feel at fault. It’s
important for the close family and friends of anyone
diagnosed with PTSD to remain supportive, stay informed,
have hope. Treatment can be very effective.
TREATMENTS
Different forms of Cognitive Behavioral Therapy (CBT) -
most common and most strongly recommended
Cognitive Processing Therapy (CPT) - helps patients
learn how to modify and challenge unhelpful beliefs
related to trauma
Cognitive Therapy - modifying the pessimistic
evaluations and memories of trauma
Prolonged Exposure - teaches individuals to gradually
approach trauma-related memories, feelings, and
situations
Psychotherapies - conditionally recommended, but regarded as
highly effective under the right circumstances
Brief Eclectic Psychotherapy - focuses on changing the
emotions of shame and guilt
Eye Movement Desensitization and Reprocessing (EMDR)
Therapy - attempts to reduce the vividness and emotion
associated with trauma memories
Narrative Exposure Therapy (NET) - helps individuals establish
a coherent life narrative in which to contextualize traumatic
experiences
Medication (FDA approved only) - also
conditionally recommended
Sertraline (Zoloft) - antidepressant that
increases serotonin levels in the brain; helps
regulate mood, anxiety, and sleep (effective in
over 50% of cases, main side effect is nausea)
Paroxetine (Paxil) - reduction of re-
experiencing, avoidance, and hyper-arousal
symptoms (also over 50% effective in clinical
trials, has more side effects than Zoloft)
STATISTICS AND QUICK FACTS
About 7-8% of people will experience The average delay between
PTSD at some point in their lives experiencing a traumatic event and
6.8% of Americans will develop PTSD seeking treatment for PTSD is
within their lifetime (9.7% for women, approximately 12 years
3.6% for men; women are twice as likely About 20-30% of first responders, such
to get PTSD than men) as firefighters, police officers, and
Among U.S. military veterans, the paramedics, develop PTSD at some
estimated prevalence of PTSD is around point in their careers
10-20%
PTSD prevalence in PA is 5.7%
The lifetime prevalence of PTSD in
Individuals with a history of childhood
individuals who have experienced sexual
abuse or neglect are at higher risk for
assault is around 50%.
developing PTSD in adulthood
CURRENT RESEARCH
Lots of research is still being done on the most effective
ways to treat PTSD, including both medication and
therapy approaches. In 2024, a study funded by the
National Institute of Mental Health found that
collaborative care significantly reduced PTSD symptoms
among trauma patients from racial and ethnic minority
backgrounds. Studies are also being done to track brain
changes that occur after traumatic events, as well as
patterns in the development of PTSD (Who develops it
and why?, What does their brain look like before vs.
someone who does not develop the disorder?, etc.)
