Post-traumatic stress disorder (PTSD) is a condition marked by increased stress and anxiety following a traumatic or stressful event. A diagnosis of PTSD can apply to adults, adolescents and children. A person can be diagnosed with PTSD if exposed to actual or threatened death, serious injury or sexual violence in one or more of the following ways:
Epidemiology of PTSD
Symptoms of PTSD
In addition, a diagnosis of PTSD requires that the affected individual demonstrates the following traits for more than 1 month:
Effective treatments for PTSD include both psychotherapy and pharmacotherapy.
Psychotherapeutic approaches for patients with PTSD include behavior therapy, cognitive therapy, hypnosis, and eye movement desensitization and reprocessing (EMDR). In addition to individual therapy, group therapy and family therapy can be effective approaches. Group therapy offers the advantages of sharing of traumatic experiences and support from other group members. Family therapy often helps sustain a marriage or partnership through periods of exacerbated symptoms.
Selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft) and paroxetine (Paxil) reduce symptoms from all PTSD symptoms and are considered first-line treatments for PTSD. Other drugs shown to be effective include tricyclic drugs imipramine (Tofranil) and amitriptyline (Elavil). Other drugs that may be useful in the treatment of PTSD include monoamine oxidase inhibitors (MAOIs) and anticonvulsants.
Yes. Approximately two-thirds of individuals with PTSD have at least two other mental health disorders. Common comorbid conditions include depressive disorders, substance-related disorders, anxiety disorders, and bipolar disorders. These disorders make people more vulnerable to develop PTSD.
Like post-traumatic stress disorder (PTSD), acute stress disorder is a condition marked by increased stress and anxiety following a traumatic or stressful event. A person can be diagnosed with acute stress disorder if exposed to actual or threatened death, serious injury or sexual violence in one or more of the following ways:
A diagnosis of acute stress disorder requires significant distress or impairment in social, occupational, or other important areas of functioning for at least 3 days and up to one month. Symptoms are required in nine or more of the following five categories of intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred.
Yes. A diagnosis of “unspecified trauma- or stress-related disorder” is used for patients who have symptoms in response to an identifiable stressor but do not meet the full criteria of any specified trauma- or stressor-related disorder (e.g., acute stress disorder, PTSD, or adjustment disorder). For example, their symptoms may occur more than 3 months after the stressor, or their symptoms may last longer than 6 months. The symptoms cannot meet the criteria for another mental or medical disorder, and cannot be attributed to the physiological effects of a substance.
An adjustment disorder is a depressive or anxious condition resulting from an emotional response to a stressful event. Typically, the stressor involves financial issues, a medical illness, or relationship problem. For a diagnosis of adjustment disorder, symptoms must begin within 3 months of the stressor.
Symptoms of an adjustment disorder include one or both of the following:
Psychotherapy remains the treatment of choice for adjustment disorders. Individual psychotherapy offers patients the opportunity to explore the meaning of the stressor so that earlier traumas can be worked through. After successful therapy, patients sometimes emerge from an adjustment disorder stronger than before. Group therapy can be helpful for patients who share the same types of issues.
Reactive attachment disorder is a condition demonstrated by children between the ages of 9 months and 5 years who show a consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers. The child rarely or minimally either seeks comfort or responds to comfort when distressed.
A diagnosis of reactive attachment disorder is characterized by at least two of the following symptoms:
In addition, the child has experienced a pattern of insufficient care as evidenced by at least one of the following:
Disinhibited social engagement disorder is a pattern of behavior in which a child approaches and interacts with unfamiliar adults and demonstrates at least two of the following: