Monday, March 28, 2011

What Is Posttraumatic Stress Disorder?

On my radio show that airs today, I interview a man who has struggled with Posttraumatic Stress Order (PTSD) since 1979 when the airplane he was flying crashed. I listed a few of the prominent diagnostic indicators of this condition on air and promised that I would post the rest on my web site. Here they are, excerpted from the Diagnostic Criteria from DSM-IV. The DSM is the clinician’s Bible for diagnosing mental illnesses.

A. The person has been exposed to a traumatic event in which both of the following
were present:

(1)The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.

(2)The person’s response involved intense fear, helplessness, or horror.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

(1)recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions;

(2)recurrent distressing dreams of the event;

(3)acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated);

(4)intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event;

(5)physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by three (or more) of the following:

(1)efforts to avoid thoughts, feelings, or conversation associated with the trauma;

(2)efforts to avoid activities, places, or people that arouse recollections of the trauma;

(3)inability to recall an important aspect of the trauma;

(4)markedly diminished interest or participation in significant activities;

(5)feelings of detachment or estrangement from others;

(6)restricted range of affect ( e.g., unable to have loving feelings)

(7)sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span).

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

(1)difficulty falling asleep;

(2)irritability or outbursts of anger;

(3)difficulty concentrating;


(5)exaggerated startle response;

E.Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F.Disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Acute: if duration of symptoms is less than three months

Chronic: if duration of symptoms is three months or more

With delayed onset: if onset of symptoms is at least six months after the stressor.

As you look over this list of symptoms of PTSD, imagine the stress that this condition places on the individual who has this illness, as well as on his/her intimate relationship.