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Overview of PTSD

Learn more about the features of PTSD, types and possible risk factors.
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PTSD, you would recognise it by the fact that the person would be having flashbacks of the traumatic event or events, intrusive thoughts, nightmares often, and then avoidance. And avoidance is the killer, because nobody wants to think about something that’s horribly traumatic. So people with PTSD are actually really quite hard to get into treatment. And one of the most interesting things I think that’s happened in the last 20 years or so, is there being some really good randomised controlled trials of treatment for PTSD. And they’ve actually shown that you can cause harm by pushing your way in there as a therapist, and saying to someone, you’ve got PTSD, you better sit down and talk about it.
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I actually, after a natural disaster for example, or in a war situation where there’s been a lot of trauma, we think that the best thing you can do is hang around your nearest and dearest. Hopefully your family, if they’re still alive. If not, members of the community that you know. My hunch says that what you need to be doing is having lots of cups of tea or soup with people that you know and love. And when you’re ready for treatment, then you might need treatment. And if that’s the case, then there are some very effective treatments for Post-Traumatic Stress Disorder, like EMDR, trauma-focused cognitive behavioural therapy, those kind of things.

In this short video, Prof. Helen Minnis highlights some of the distinguishing features of PTSD, considers how people exposed to traumatic events can best be supported in the immediate aftermath and briefly discusses research progress in this area.

Photo of Prof. Helen Minnis Helen Minnis is a Professor of Child and Adolescent Psychiatry at the University of Glasgow. Professor Minnis spent time working as an Orphanage Doctor in Guatemala in the early 1990s prior to training in Psychiatry, and this stimulated an interest in the effects of early maltreatment on children’s development.

Types of PTSD

The image shows a timeline from traumatic event to nine months laterThe image shows a timeline from traumatic event to nine months later, showing the different ways PTSD can be classified depending on when the onset is. click to see larger version

Although individuals may experience PTSD symptoms immediately following a traumatic event, symptoms must persist for at least 1 month following exposure in order for a diagnosis of PTSD to be made. Trauma symptoms that develop within a month of the event, and last less than one month, indicate a diagnosis of Acute Stress Disorder. If PTSD symptoms persist after 1 month of the traumatic event but last less than 3 months, a diagnosis of Acute PTSD is appropriate. However, if these symptoms persist beyond 3 months, a diagnosis of Chronic PTSD is applicable. Finally, should symptoms develop 6 months after the event, a diagnosis of Delayed-Onset PTSD can be made.

Complex PTSD

Complex PTSD may develop following exposure to an event or a series of events of an extremely threatening nature. Most commonly, the events are prolonged or repetitive. They are usually difficult, or indeed impossible, to escape from. Such events may include: torture, slavery, genocide, prolonged domestic violence, and repeated sexual or physical abuse.

For a diagnosis of complex PTSD to be made, all the diagnostic requirements for PTSD are met. Additionally, complex PTSD is characterised by “severe and persistent:
  • problems in affect regulation
  • beliefs about oneself as diminished, defeated or worthless, accompanied by feelings of shame, guilt or failure related to the traumatic event
  • difficulties in sustaining relationships and in feeling close to others.
These symptoms cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning.” (WHO, 2019)

Reflect on, and make some personal notes about, the implications of this diverse presentation of PTSD for the prevention and treatment of the disorder.

References

World Health Organisation. (2019). International Statistical Classification of Diseases and Related Health Problems (11th Revision). https://icd.who.int/en/

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Post-Traumatic Stress Disorder (PTSD) in the Global Context

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