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Symptoms and Definition of Posttraumatic Stress Disorder (PTSD)

By definition, PTSD is the result of a traumatic event where both of the following occurred:

  1. The individual experienced, witnessed or was confronted by an event that involved actual or threatened death, serious injury, or a threat to the physical integrity of oneself or others. Examples include:
    1. Experiencing military combat, rape, assault, torture, terrorist attacks, natural or man-made disasters, serious motor vehicle accidents, or being diagnosed with a life-threatening illness.
      • For children, sexually traumatic events can include developmentally inappropriate sexual experiences without any threatened or actual violence or injury.
    2. Witnessing the serious injury or unnatural death of another person or unexpectedly discovering a dead body or body parts.
    3. Learning about the unexepcted death, serious injury or illness of a family member or close friend.
  2. The individual experienced intense fear, helplessness or horror in response to the event. In children, this may be expressed instead by disorganized or agitated behavior.

The traumatic event is persistently reexperienced in one or more of the following ways:

  • Flashbacks
  • Nightmares (in children, these may not have any clear references to the traumatic event)
  • Having a sense of reliving the traumatic event, which can include illusions and hallucinations. (These illusions and hallucinations are usually related in some way to the traumatic event.)
  • Experiencing intense distress, such as anxiety, fear, or panic attacks, when something reminds the individual of the traumatic event.
  • Children may reenact the traumatic event repetitively in their play and games

The individual tries to avoid anything that reminds them of the traumatic event in three or more of the following ways:

  • Avoiding any thoughts, feelings or discussions about the event
  • Avoiding going to any places or participating in any activities that may remind them of the event
  • Being unable to recall important details of the traumatic event
  • Losing interest in certain activities that had previously been significant for the person
  • Feeling detached or estranged from others
  • Feeling numb and unable to experience any strong feelings
  • Having a sense of a foreshortened future, as if one's life will likely end prematurely and as if it is unlikely that one will have a career, marry, have children, etc.

The person as two or more of the following symptoms of hyperarousal:

  • Difficulty falling or staying asleep
  • Feeling very irritable or having outbursts of anger
  • Difficulty concentrating
  • Being hypervigilent, where one is constantly scanning their environment to watch for any possible dangers and sometimes misinterpreting minor noises and such as signs of danger.
  • Startling very easily and in an exaggerated way

For a diagnosis of PTSD to be made, the above symptoms need to be present for at least 1 month and to cause significant distress or an impairment in the person's ability to function in school or at work or to remain invested in their relationships.

In addition, one's course of PTSD can be described in the following ways:

  • Acute: the symptoms have been present for less than 3 months
  • Chronic: the symptoms have been present for more than 3 months
  • With Delayed Onset: the symptoms started at least 6 months after the traumatic event.

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Overview

Acute Stress Disorder