POST TRAUMATIC STRESS DISORDER

Post Traumatic Stress Disorder

Post Traumatic Stress Disorder

Introduction

Post Traumatic Stress Disorder (PTSD) has been the focus of considerable attention, and some controversy, since it was formally recognised in 1980 by the American Psychiatric Association. This essay will discuss the history of this relatively new diagnosis and its place within the DSM-IV-TR, whilst three perspectives of pathological reaction to trauma, namely, socio-cultural, psychological and biological factors will also be compared. In conclusion this essay will discuss how the three perspectives contrast and contribute to our understanding of PTSD.

PTSD is a common anxiety disorder in United States with a twelve month prevalence of 3.3% (Comer, 2002, p. 142) and in its more serious forms, it is a chronic and disabling psychiatric disorder associated with high co-morbidity and impairment of functioning. The essential feature of PSTD is the development of characteristic symptoms following exposure to an extreme traumatic stressor. This can be a direct personal experience which involves actual or threatened death or serious injury, or witnessing such an event. PTSD is defined by Comer (2002, p. 142) as an anxiety disorder in which fear and related symptoms continue to be experienced long after the traumatic event. PTSD is characterised by the persistent re-experiencing of the traumatic event either in intrusive painful recollections and flashbacks or in dreams, avoidance of situations that trigger the recollection of trauma, numbing of general responsiveness and signs of hyper-arousal.

Definition

The criteria for traumatic stress is defined in DSM-IV-TR as an event either witnessed or experienced which then creates intense feelings of fear, helplessness or horror. Examples of traumatic stressors can include, but are not limited to, plane crashes, sexual assault and rape, war, terrorist attacks, natural disasters such as floods and bushfire and motor vehicle accidents. The DSM subdivides PTSD into two different types: acute, in which the symptoms last less than three months, and chronic, in which they last three or more months (Green & Roberts 2008, p.193). Since the introduction of DSM-IV-TR, the number of possible PTSD traumas has increased and one study suggests that the increase is around 50% (APA 2002, p. 4467)Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria, and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. The fifth criterion concerns duration of symptoms and a sixth assesses functioning. PTSD differs from other anxiety disorders in that the source of stress is an external event of an overwhelmingly painful nature.

Causes

Most of our knowledge of PTSD comes from war survivors, people who lived through concentration camps, and victims of combat from WWII, Korean and Vietnam wars (Bootzin & Ross 1988, p.176). Based on research to date it is believed that PTSD is caused by a combination of several factors including social, biological and psychological and each help contribute to our understanding of the disorder.

1. Socio-cultural Factors

According to Martz, Livneh and Wright, (2007) race, sex, ethnicity and culture shape conceptualisation of events, individual reactions to trauma, expectations and ...