Posttraumatic Stress Disorder Introduction

Posttraumatic stress disorder (PTSD) is an anxiety disorder that can develop after exposure to a traumatic event. A traumatic event is a highly unpredictable and unpleasant incident that produces intense feelings of distress, fear, horror, and helplessness. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a traumatic event that can trigger posttraumatic stress disorder includes: (1) direct personal experience with an event that involves actual or threatened death, physical harm, or serious injury, (2) being witness to an event that involves death, injury, or threat to the physical integrity of another person, or (3) learning about an unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or friend.

Initially, posttraumatic stress disorder symptoms were identified in war veterans as early as the American Civil War and were associated with events experienced during war (such as combat, being taken prisoner, torture, war conditions). However, the term that refers to the condition had changed over the years until it was formally accepted as posttraumatic stress disorder in 1980.

Posttraumatic stress disorder can be triggered by a wide variety of incidents. The most common traumatic events besides combat and war exposure include:

When exposed to traumatic events, it is normal for individuals to experience intense feelings of fear, distress, horror, and helplessness, but when the event is over these feelings usually go away. Posttraumatic stress disorder is diagnosed when the traumatic event and its related distress feelings are re-experienced in the mind for a period longer then four weeks.

Individuals with posttraumatic stress disorder are easily startled, irritable, can be more aggressive and violent than normal, and manifest a lack of interest in activities that were previously enjoyable. They also experience an emotional numbing in relations with people they used to be close to and have difficulty feeling affectionate. Some individuals with PTSD describe painful feelings of guilt about surviving in conditions where others were unable to make it, or about the circumstances that help them survive. They have a hopeless perception about their future by expecting to not have a career, marriage, family, children, or a normal life.

An essential characteristic of posttraumatic stress disorder is experiencing "flashbacks" of the traumatic event. A flashback is usually a brief episode of "intrusive recollections of the event", either through thoughts during the day, or nightmares during the night. In rare cases, individuals can experience dissociative states (that can last between a few seconds to several hours or days) where the individual relives the traumatic event and acts as though the event is happening at that moment. These flashbacks can be triggered by stimuli such as anniversaries of the traumatic event, or triggering events that resemble or symbolize an aspect of the traumatic event (being in an elevator for a woman that was raped in an elevator), and causes prolong psychological distress and physiological reactivity. These symptoms seem to be more severe or long-lasting if the traumatic event was deliberately initiated by another person.

Individuals with PTSD usually engage in deliberate avoidance behaviors such as avoiding thoughts, feelings, conversations, activities, situations, and even people that are connected to the traumatic event. When avoiding reminders of the traumatic event, the individual can develop amnesia (are unable to recall an important aspect of the event).

Posttraumatic stress disorder can affect the person's quality of life leading to marital conflicts, deteriorated interpersonal relationships, and occupational problems.

Approximately 7.8 million American adults suffer from PTSD at some point in their life. About 3.6 percent of U.S. adults age 18 to 54 will suffer from posttraumatic stress disorder during a given year. According to the Canadian Mental Health Association, 1 in 10 people are affected by PTSD. Both, adults and children, can develop posttraumatic stress disorder. It affects more women (10 percent) than men (5 percent), and is often associated with depression, substance abuse, and one or more of the other anxiety disorders.

Conditions & Diseases: Psychological & Mental Health

Posttraumatic Stress Disorder