Posttraumatic stress disorder is an extreme response to severe stressor. It involves recurrent memories of trauma, avoidance of stimuli associated with trauma, negative emotions and thoughts, and increased arousal. PTSD is the response to a serious trauma as an event that involved actual or threatened death, serious injury, or sexual violation where 55% of people report at least one lifetime serious trauma. Common traumas preceding PTSD are military trauma for men and rape for women. The symptoms may develop soon after the trauma and can be chronic. However, sometimes symptoms do not develop for years. Unemployment and suicidality are common. High rates of medical illness have been reported and prolonged exposure to trauma may lead to a broader range of symptoms that may result in complex PTSD. The DSM-5 criteria for PTSD is the exposure to a serious trauma and symptoms in the four following categories of intrusion, avoidance, persistent negative alternation in cognitions and mood, and recurrent changes in arousal and reactivity. Intrusion is recurrent and intrusive memories, dreams, and flashbacks. Avoidance involves avoiding internal and external reminders. Persistent negative alternation in cognitions and mood are negative beliefs and negative emotional states. Recurrent changes in arousal and reactivity are aggressiveness, hypervigilance, and exaggerated startle response. PTSD is usually comorbid with other conditions such as anxiety disorders, depression, substance use, conduct disorder, and personality disorder. PTSD is 1.5 to 2 times more likely in women and is consistent with the gender ratio in other anxiety disorders. It may be related to different life circumstances of women. Culture may shape the risk of PTSD including exposure to trauma and the types of symptoms observed. Acute stress disorder has symptoms similar to PTSD however there is a shorter duration of symptoms lasting 3 days to 1 month after trauma. The diagnostic symptom criteria are broader than for PTSD and do not have to fall into specific categories. ASD may stigmatize reactions to serious trauma as 90% of women report significant symptoms 1 month after a rape. ASD is not very predictive of who develops PTSD as less than half develop PTSD within 2 years.
While medication and psychological treatments are both available for the treatment of PTSD, treatments must carefully be evaluated as to what treatment would be the most effective. A meta-analysis addressed the ongoing debate of which treatments should be used and how to properly diagnose PTSD. The analysis explained that when choosing the path of psychological treatment for PTSD that the patient’s demographics, the intensity, the service delivery, the types of trauma, and types of therapy must all be considered. After reviewing multiple sources, it was concluded that the most effective forms of psychological treatment are web-based therapies, various duration and intensity therapies, group therapies, empirically supported psychological treatments in adults or children, and trauma-focused or non-trauma focused treatments. These forms of treatment were all agreed upon to be classified as highly effective psychological treatments for PTSD in patients.
Lee, E., & Bowles, K. (2020). Navigating treatment recommendations for PTSD: A rapid review. International Journal of Mental Health, 1–41. https://doi.org/10.1080/00207411.2020.1781407