Posttraumatic Stress Disorder
By Sh ik ha Pa ndey
Posttraumatic stress disorder (PTSD) is classified in the DSM-5 as a Trauma- and Stressor-Related
Disorder.
Individuals who suffer from PTSD re-live distressing instances of the traumatic event, with vivid
emotional proximity and high, imperative intensity. They organize their lives trying to contain and
mitigate the persistent effects of the traumatic experience. For those traumatized in a warzone, “the
war never ends.” Victims of rape, assault, or torture describe difficulties engaging and trusting other
humans. Constantly re-living the trauma in the present, PTSD patients’ lives become a series of
effortful attempts to avoid reminders of the traumatic event. They scan the environment for threat
signals, which they fearfully expect, and remain on guard, tense, restless, and exhausted.
PTSD is a trauma and stress-related disorder, defined by the co-occurrence of re-experiencing,
avoidance, negative beliefs and hyper arousal symptoms, in survivors of extreme adversity. PTSD is a
common outcome of all types of traumatic events, from most horrifying and protracted (e.g.,
captivity and torture) to shorter events or incidents (e.g., accidents). The construct of PTSD has, in
fact, replaced several event-related “syndromes” that pre-existed its definition (e.g., “concentration
camp syndrome,” “war neurosis,” or “rape victim syndrome”).
Unlike most other mental disorders, the diagnosis of PTSD relies on associating current symptoms
with a triggering traumatic life event (e.g., depression can be diagnosed regardless of its eventual
onset following a life event). The association can be chronological (symptoms starting shortly after
the event) or content related (intrusive recollections of the traumatic event or avoidance of
reminders). The essential features of DSM-5 PTSD is the development of characteristic symptoms
following exposure, witnessing or indirect exposure to one or more traumatic events.
DSM-5 parses PTSD symptoms into four subcategories (“diagnostic re-experiencing, avoidance,
negative cognitions, and criteria”): hyper-arousal. To qualify for diagnosis of PTSD, a trauma-exposed
individual must express a predefined minimal number of symptoms in each category.
The following criteria apply to adults, adolescents, and children older than 6 years.
A. Exposure to actual or threatened death, serious injury, or sexual violence.
B. Presence of one (or more) of the intrusion symptoms associated with the traumatic event(s),
beginning after the traumatic event(s) occurred.
C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the
traumatic event(s) occurred.
D. Negative alterations in cognitions and mood associated with the traumatic event(s),
beginning or worsening after the traumatic event(s) occurred.
