Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is the most common psychiatric consequence of trauma exposure. Trauma may include an event in which a person is exposed to actual or threatened death, serious injury, or sexual violation, or an event in which the person witnesses first-hand such an event. PTSD is an array of psychological and physiological reactions that are expected, normal responses to life threat, but that persist beyond a normal period of recovery. In PTSD these persistent reactions are intense and debilitating, and continue long after the traumatizing event has ended. In this way, PTSD can be described as a disorder of non-recovery.

Common reactions to trauma exposure include: intrusive recollections of the trauma, trauma-related nightmares, haunting thoughts about what the experience means, emotional and physiological reactivity to reminders of the trauma, problems sleeping, loss of interest and pleasure, increased startle response, difficulty concentrating, irritability and anger, and hypervigilance. 

A key feature of PTSD is avoidance of memories and reminders of the trauma. Avoidance behaviors are credited with chronicity of the disorder because they set up a vicious cycle:
Distress undermines memories [leading to] →Inaccurate interpretations → More distress → Coping by avoiding the memories and all reminders → Continued inaccurate explanations and high distress with memories.

Fortunately PTSD can be successfully treated! Several treatment protocols have been empirically demonstrated to result in clinically significant reductions in PTSD symptoms for a majority of subjects as well as remission of PTSD for many. For most people, these improvements persist years after treatment is complete. The Veterans Health Administration (VHA) and Department of Defense (DoD) Clinical Practice Guidelines for the Treatment of PTSD list Cognitive Processing Therapy (CPT), Prolonged Exposure therapy (PE), Stress Innoculation Therapy (SIT) and Eye-Movement Desensitization and Reprocessing (EMDR) as evidence-based psychotherapies for PTSD (United States Department of Veterans Affairs (2010). VA/DoD Clinical Practice Guideline for the Management of Post-Traumatic Stress.)