Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a term for certain psychological consequences of exposure to, or confrontation with, stressful experiences that the person experiences as highly traumatic. These experiences can involve actual or threatened death, serious physical injury, or a threat to physical and/or psychological integrity. It is occasionally called post-traumatic stress reaction to emphasize that it is a routine result of traumatic experience rather than a manifestation of a pre-existing psychological weakness on the part of the patient. more...

Symptoms can include the following: Nightmares, flashbacks, emotional detachment or numbing of feelings (emotional self-mortification or dissociation), insomnia, avoidance of reminders and extreme distress when exposed to the reminders ("triggers"), irritability, hypervigilance, and and excesive startle response.

Experiences likely to induce the condition include:

• childhood physical/emotional or sexual abuse
• adult experiences of rape, war and combat exposure
• violent attacks
• natural catastrophes
• life-threatening childbirth complications

For most people, the emotional effects of traumatic events will tend to subside after several months. If they last longer, then diagnosing a psychiatric disorder is generally advised. Most people who experience traumatic events will not develop PTSD. PTSD is thought to be primarily an anxiety disorder, and should not be confused with normal grief and adjustment after traumatic events. There is also the possibility of simultaneous suffering of other psychiatric disorders (i.e. comorbidity). These disorders often include major depression or general anxiety disorder

PTSD may have a "delayed onset" of years, or even decades, and may even be triggered by a specific body movement if the trauma was stored in the procedural memory, by another stressful event, such as the death of a family member or someone else close, or by the diagnosis of a life-threatening medical condition.

Also, doctors have conducted clinical studies indicating traumatized children with PTSD are more likely to later engage in criminal activities than those who do not have PTSD.

Background

Psychological distress after trauma was reported in 1900 BC by an Egyptian physician who described hysterical reactions to trauma (Veith 1965). Hysteria was also related to "traumatic reminiscences" a century ago (Janet 1901). At that time, Sigmund Freud's pupil, Kardiner, was the first to describe what later became post-traumatic stress disorder symptoms (Lamprecht & Sack 2002).

Hippocrates utilized a homeostasis theory to explain illness, and stress is often defined as the reaction to a situation that threatens the balance or homeostasis of a system (Antonovsky 1981). The situation causing the stress reaction is defined as the "stressor", but the stress reaction, and not the stressor is what jeopardizes the homeostasis (Aardal-Eriksson 2002). Post-traumatic stress can thus be seen as a chemical imbalance of neurotransmitters, according to stress theory.

However, PTSD per se is a relatively recent diagnosis in psychiatric nosology, first appearing in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. It is said development of the PTSD concept partly has socio-economic and political implications (Mezey & Robbins 2001). War veterans were to a great deal incapacitated by psychiatric illness, including post-traumatic stress in the aftermath of the Vietnam War. However, they had difficulties receiving economic compensation since there was no psychiatric diagnosis available by which veterans could claim indemnity. This situation has changed, and PTSD is now one of several psychiatric diagnoses for which a veteran can receive compensation, such as a war veteran indemnity pension, in the US (Mezey & Robbins 2001). While PTSD-like symptoms were recognized in combat veterans following many historical conflicts, the modern understanding of the condition dates to the 1980s.

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