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Post Traumatic Stress Disorder (PTSD)

Post Traumatic Stress Disorder (PTSD)

The Post Traumatic Stress Disorder or PTSD It is currently conceived as a disorder that appears as response to a highly stressful situation or "traumatic." This disorder is characterized by the presence of the following symptomatic manifestations related to exposure to that traumatic event.

Content

  • 1 Origin and classification of PTSD
  • 2 Main symptoms of PTSD
  • 3 Treatment of PTSD

Origin and classification of PTSD

As stated in the DSM-V Diagnostic Manual: Many people who survive extremely traumatic events develop PTSD. Combat survivors are the most frequent victims, but they are also identified in individuals who faced other disasters, both natural and induced. They include rape, floods, kidnappings and aviation accidents, as well as threats that may involve kidnapping or hostage taking. Children may take PTSD as a result of an inappropriate sexual experience, whether or not they suffer an injury. PTSD can be diagnosed even in those who only learned of some severe trauma (or threat) suffered by someone close-children, spouses, other close relatives. One or two of every 1,000 patients who undergo general anesthesia report after having been aware of pain, anxiety, helplessness and fear of imminent death during the procedure; Up to half of them can subsequently develop symptoms of PTSD.

This classification excludes stressful experiences from everyday life, such as grief, divorce and serious illness. The awakening of anesthesia while the surgery is still going on, however, could be considered a traumatic event, as well as finding out the sudden accidental death of the spouse and a life-threatening illness.

After a certain period (the symptoms do not usually develop immediately after the trauma), the individual somehow recalls the traumatic event and tries to avoid thinking about it. There are also symptoms of physiological hyperactivation, such as exaggeration of the startle response. PTSD patients also express negative feelings, such as guilt or personal responsibility ("I should have avoided it").

In addition to the traumatic event itself, other factors may participate in the development of PTSD. Between the individual factors the innate character of the person and the genetic inheritance are found. The low level of intelligence and poor educational preparation show a positive association with PTSD. Between the environmental factors there is low socioeconomic status and membership in a racial or ethnic minority group.

Usually, the more terrible or prolonged the trauma, the greater the likelihood of PTSD developing. The risk is increased to reach a quarter of the survivors of intense combat and two thirds of those who were prisoners of war. Those who faced disasters due to natural phenomena, such as fires or floods, generally tend less to develop symptoms.

Older adults are less likely to develop symptoms than younger ones, and women tend to show slightly higher rates than men. About half of the patients recover within a few months; others may experience disability for years.

Main symptoms of PTSD

Intrusive re-experimentation of the traumatic event

Some authors consider that symptoms of this type are "the contrast mark" of PTSD. These are re-experiences of the traumatic event of an intrusive nature, which can cause the person a stress and anxiety reaction very similar to that occurred in the face of the original trauma. Symptoms ranging from flashbacks, nightmares, etc. are included here. There are authors who indicate that this re-experimentation can lead to a "re-traumatization", self-perpetuating the trauma, and "fixing" the person in an event to which he is continually being re-exposed.

Avoidance

The avoidance of trauma reminders is one of the central symptoms of PTSD, and it can manifest itself in different ways. On the one hand, the person can present avoidance behaviors so as not to have to face any reminder of the traumatic experience. Reminders can be people, situations or circumstances that resemble or are in some way associated with the event. On the other hand, people with PTSD often try to keep memories away from their minds and avoid thinking or talking in detail about the event, especially in the worst moments. However, it also happens that the person ruminating excessively about the aspects that could prevent the event, about the reasons or why it had to happen to them, or about how to take revenge on the event. On the other hand, the person can avoid memories of trauma through dissociative mechanisms or symptoms of amnesia. Another form of avoidance that usually develops, and that we will see next, has to do with the experimentation of emotions, especially with the emotions “intolerable” for the person, tried in many cases to “anesthetize” emotionally, either by showing affective “detachment” , through substance use, excessive dedication to work or other activities, etc.

Dullness

Many authors consider that blunt symptoms are a way of avoidance that occurs specifically in PTSD. Numbness can be expressed as depression, anhedonia, lack of motivation, but also as psychosomatic reactions, or dissociative states. It should be borne in mind that, as indicated below, in many cases people with this disorder have difficulties controlling their emotions, and precisely because of this they try to avoid disturbing internal sensations.

Regional hyperactivation

Although people with PTSD are usually characterized by emotional constriction, however their bodies seem to continue to react to certain emotional and physical stimuli as if the threat still persists, although this autonomic activation no longer has the adaptive function of alerting the organism of a danger. This hyperactivation has associated sleep problems. On the one hand, they may be unable to calm down enough to go to sleep, and on the other they may be afraid of their nightmares. Many people with PTSD report that their sleep is interrupted, they wake up as soon as they start having a dream, for fear that it becomes a nightmare. On the other hand, these people also report excessive hypervigilance, and exaggerated startle response. The physiological hyperactivation experienced by these people also interferes with their ability to concentrate. Apart from the problems of amnesia about certain aspects of trauma, these people often have trouble remembering everyday things. They may even lose maturational achievements, and return to previous stages of coping with stress, such as losing their ability to take care of themselves, excessive dependence, making autonomous decisions, controlling sphincters in children, etc.

Intense emotional reactions

Difficulties appear in the regulation of affection. These people can respond to stimuli with intense and disproportionate reactions (anger, anxiety, panic, etc.), which can even intimidate others. But they can also be paralyzed.

Aggressive behavior towards others and towards themselves

Many studies have indicated that traumatized people can manifest aggressive behavior towards others or themselves. For example, child abuse increases the likelihood of criminal and criminal behavior in adulthood.

PTSD treatment

PTSD treatment is done with psychotherapy and medication. In psychotherapy, anxiety management is worked through relaxation, meditation, learning to replace negative thoughts with positive ones, and learn to curb thoughts that cause anxiety.

Cognitive Therapy and Exposure Therapy, which involves exposing yourself both imaginary and in reality to situations that recall trauma, without triggering symptoms.

The medications used to treat PTSD are antidepressants, from the new generation to the old ones. In addition, drugs that stabilize mood and anxiolytic medication can be used for the treatment of anxiety at specific times where it is not possible to control it.

References

American Psychiatric Association (2000).Diagnostic and Statistical Manual of Mental Disorders. (DSM-IV-TR). Washington, D.C .: American Psychiatric Association

Barlow, D.H. (1988). Anxiety and its disorders: the nature and treatment of anxiety andpanic. New York: Guilford

Brende, J. (1985).The use of hypnosis in posttraumatic conditions. In W. E. Kelly (Ed.), Post-traumatic stress disorder and the war patient (pp. 193-210). New York: Brunner / Mazel.

Breslau, N., Davis, G.C., and Andreski, P. (1991). Traumatic events and post traumatic stress disorder in an urban population of young adults. Archives of General Psvchiatrv. 48, 216-222.

Brewin, C.R., McNally, R.J. and Taylor, S. (2004). Point-counterpoint: two views of traumatic memories and post-traumatic stress disorder. Journal of Cognitive Psychotherpay, 18, 99-114

Echeburúa, E. (2004): Overcome trauma treating victims of violent events. Madrid: Pyramid

Echeburúa, E. and De Corral, P. (1997). Advances in cognitive behavioral treatment of Post-traumatic Stress DisorderAnxiety and Stress, 3, 249-264.

Foa, E. B., and Rothbaum, B. O. (1998). Treating the trauma of monkfish. Cognitive-behavior therapy for PTSD. New York: Guilford.

Herman, J. L. (1992a). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5, 377-391.

Keane, T. M., Zimering, R. T., and Caddell, J. M. (1985). A behavioral formulation of post-traumatic stress disorder. The Behavior Therapist, 8, 9-12.

Orsillo, S. M .; Batten, S.V. (2005) Acceptance and Commitment Therapy in the Treatment of Posttraumatic Stress Disorder Behavior Modification, 29 (1), 95-129

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