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POST TRAUMATIC STRESS DISORDER:
Post Traumatic Stress Disorder(PTSD) came into existence in order to provide a description for disorders and symptoms in which the
stressor seemed to be of a "catastrophic" nature, and was clearly demanded by a socio-political reality: the large numbers of soldiers
who suffered disorders after the Vietnam War were difficult to ignore. There were, however, many previous attempts to give
expression to the effects of trauma that were not easily covered by the existing nosologies. These earlier descriptions had been
classified mainly by reference to the precipitating event, and "concentration camp syndrome", "post-Vietnam syndrome", and "rape
trauma syndrome" are all well-known examples of this approach to classification (Rasmussen.1990). However, impetus for a specific
classification for disorders caused by trauma came with the recognition that diverse forms of trauma seemed to produce similar clinical
pictures in the sufferers.
This recognition, that diverse stressors could produce remarkably similar effects, was codified in DSM-III in 1980 with the invention of
Post Traumatic Stress Disorder. This was quickly followed by clinical studies and research, and resulted, in 1987, in the amended
definition and description given in the revised version of DSM-III (APA.1987). Some brief consideration should be given to these two
descriptions and to the amendments that have taken place. There are also plans to further amend this last definition (McNally.1993).
Post Traumatic Stress Disorder: DSM-III
A.
Existence of a recognizable stressor that would evoke significant
symptoms of distress in almost everyone.
B. Re-experiencing the event as evidenced by at least one of the
following:
(1) recurrent and intrusive recollections of the event
(2) recurrent dreams of the event
(3) sudden acting or feeling as if the traumatic event
were re-occurring, because of an association with
an environmental or ideational stimulus.
C. Numbing of responsiveness to or reduced involvement with
the external world, beginning some time after the trauma, as
shown by at least one of the following:
(1) markedly diminished interest in one or more
significant activities
(2) feeling of detachment or estrangement from others
(3) constricted affect
D. At least two of the following symptoms that were not present
before the trauma:
(1) hyperalertness or exaggerated startled response
(2) sleep disturbance
(3) guilt about surviving when others have not, or
about behaviour required for survival
(4) memory impairment or trouble concentrating
(5) avoidance of activities that arouse recollection
of the traumatic event
(6) intensification of symptoms by exposure to events
that symbolize or resemble the traumatic event
Post Traumatic Stress Disorder: DSM-III(R)
A.
The person has experienced an event that is outside the range
of usual human experience and that would be markedly distressing
to almost everyone.
B.The traumatic event is persistently re-experienced in at least
one of the following ways:
(1) recurrent and intrusive distressing recollections
of the event
(2) recurrent distressing dreams of the event
(3) sudden acting as if the traumatic event were
re-occurring
(4) intense psychological distress at exposure to events
that symbolize or resemble an aspect of the traumatic
event, including anniversaries of the event
C. Persistent avoidance of stimuli associated with the trauma or
numbing of general responsiveness( not present before the
trauma), as indicated by at least 3 of the following:
(1) efforts to avoid thoughts or feelings associated with
the trauma
(2) efforts to avoid activities or situations that arouse
recollections of the trauma
(3) inability to recall an important aspect of the trauma
(psychogenic amnesia)
(4) markedly diminished interest in significant activities
(5) feelings of detachment or estrangement from others
(6) restricted range of affect
(7) sense of foreshortened future
D. Persistent symptoms of increased arousal, as evidenced by at least
2 of the following:
(1) difficulty in falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response
(6) physiological reactivity upon exposure to events that
resemble an aspect of the traumatic event
E.Duration of the disturbance (symptoms in B,C, and D) of at least one
month. Specify delayed onset if onset of symptoms was at least six
months after the trauma.