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The disorder occurs after an individual is exposed to a traumatic event that is outside the realm of normal human experience (combat, natural disaster, physical assault, accident). The patient persistently reexperiences the event through intrusive recollection or nightmares, reliving of the experience (flashbacks), or intense distress when exposed.
Persistent avoidance of the event and emotional numbing may be present. The patient may have feelings of detachment, anhedonia, amnesia, restricted affect or active avoidance of thoughts or activities that may be reminders of the trauma (three required).
A general state of increased arousal persists after the traumatic event, which is characterized by poor concentration, hypervigilance, exaggerated startle response, insomnia, or irritability (two required).
Symptoms cause significant distress or impaired occupational or social functioning.
Clinical Features of Post-Traumatic Stress Disorder (PTSD)
Survivor guilt may be experienced if trauma was associated with a loss of life.
Personality change, poor impulse control, aggression, dissociative symptoms and perceptual disturbances may occur.
Risk of depression, substance abuse, other anxiety disorders, somatization disorder, and suicide is increased.
Epidemiology
Lifetime prevalence is 1-3% of the general population and is highest in young adults.
Combat soldiers and assault victims may have prevalence rates as high as 60%.
Poor coping abilities and genetic vulnerability may be predisposing factors to PTSD.
Classification of
Treatment