Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) was invented as a diagnosis by the American Psychiatric Association with the publication in 1980 of its Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III). In the United States and elsewhere, the DSM serves as a common language and standard criteria for classifying behavioral health problems following traumatic events, primarily by professionals attempting to clarify the diagnosis with individuals and populations. Professions, as a result, have an additional tool for comparing individuals' and groups' psychosocial functioning following traumatic events to determine how best to help. Helping those with PTSD varies greatly among practitioners, as does the measurement of PTSD.

The DSM has been revised five times since it was first published in 1952. PTSD is also noted in another common clinical guide, used more in Europe and other parts of the world, namely, International Classification of Diseases (ICD), 10th revision, Chapter 5: Mental and Behavioral Disorders, part of the ICD produced by the World Health Organization (WHO). Recently, the American Psychological Association made a decision to educate its members in preparation for the migration to ICD from DSM because the former focuses more on functioning than on hard-to-measure symptoms. For more information, refer to the detailed discussion of DSM elsewhere in this encyclopedia.

According to the commonly used A.D.A.M. Medical Encyclopedia, PTSD can occur at any age following any one of a number of natural or human-assisted or human-caused disasters or other frightening events such as assault, domestic abuse, being a prisoner, sexual assault, war as a civilian or warrior, terrorist attacks, major accidents, fires, and other forms of trauma.

The cause of PTSD is unknown. Psychological, genetic, physical, and social factors are involved. PTSD changes the body's response to stress and affects [Page 451]the stress hormones and chemicals (neurotransmitters) that carry information between the nerves.

The precise cause of PTSD or why traumatic events cause PTSD in some cases and not in others is unknown. Having a history of trauma may increase a person's risk for getting PTSD after a recent traumatic event. However, the symptoms are three categories within the DSM's description of PTSD: reliving, numbing, and arousal.

The traumatized who develop PTSD relive the traumatic event, which significantly affects the sufferer's day-to-day activities. These types of symptoms include, among others, flashback episodes in which their memories of the event happen over and over. Also, the traumatized may report repeated upsetting memories or nightmares of the event, accompanied by strong and uncomfortable reactions to situations that tend to cue the memories.

The second category of symptoms is associated with efforts to avoid thinking about the trauma because the traumatized often find some relief when they develop memory control. Among the symptoms in this category area (a) emotional numbing, or feeling as though one doesn't care about anything; (b) feeling detached from others—particularly those who have not had the same traumatic experiences; (c) inability to remember important aspects of the trauma; (d) inability to renew interest in normal activities since before the trauma; (e) finding relief by avoiding places, people, or thoughts that are trauma reminders; and (f) feeling that one has no future in the shadows of the trauma.

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