Post traumatic stress disorder history and symptoms

• Childhood physical, emotional, or sexual abuse, including prolonged or extreme neglect; also witnessing such abuse inflicted on another child or an adult
• Experiences and interactions that are experienced as psychological “attacks”; for example a continual perception of psychological force, invalidation or annihilation.
• Experiencing (including witnessing) an event perceived as life-threatening, such as:

1. a serious accident
2. medical complications or serious illness such as cancer
3. violent physical assault or witnessing such an event, including torture
4. adult experiences of sexual assault
5. warfare, policing and other occupations exposed to violence or disaster
6. violent, life threatening, natural (or man made) disasters
7. incarceration

Symptoms of PTSD fall into three main categories:

• Reliving the event, which disturbs day-to-day activity

• Flashback episodes, where the event seems to be happening again and again
• Repeated upsetting memories of the event
• Repeated nightmares of the event
• Strong, uncomfortable reactions to situations that remind you of the event

• Avoidance

• Emotional “numbing,” or feeling as though you don’t care about anything
• Feeling detached
• Being unable to remember important aspects of the trauma
• Having a lack of interest in normal activities
• Showing less of your moods
• Avoiding places, people, or thoughts that remind you of the event
• Feeling like you have no future

• Arousal

• Difficulty concentrating
• Startling easily
• Having an exaggerated response to things that startle you
• Feeling more aware (hypervigilance)
• Feeling irritable or having outbursts of anger
• Having trouble falling or staying asleep

• You might feel guilt about the event (including survivor guilt). You might also have some of the following symptoms, which are typical of anxiety, stress, and tension:

• Agitation or excitability
• Dizziness
• Fainting
• Feeling your heart beat in your chest
• Headache

The diagnostic criteria for PTSD, per the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as:

A. Exposure to a traumatic event

B. Persistent reexperience

C. Persistent avoidance of stimuli associated with the trauma

D. Persistent symptoms of increased arousal (e.g. difficulty falling or staying asleep or hypervigilance)

E. Duration of symptoms more than 1 month

F. Significant impairment in social, occupational, or other important areas of functioning

Notably, criterion A (the “stressor”) consists of two parts, both of which must apply for a diagnosis of PTSD. The first (A1) requires that “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.” The second (A2) requires that “the person’s response involved intense fear, helplessness, or horror.” The DSM-IV-TR criterion differs substantially from the previous DSM-III-R stressor criterion, which specified the traumatic event should be of a type that would cause “significant symptoms of distress in almost anyone,” and that the event was “outside the range of usual human experience.” Since the introduction of DSM-IV, the number of possible PTSD traumas has increased and one study suggests that the increase is around 50%.^[1]

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