Abuse Victim: Not PTSD, Rarely CPTSD (Complex Trauma): Posttraumatic Stress Disorder

PTSD: survivors of traumatic experiences (natural disasters, crime, war, mass shootings)

Sleep disturbances, startle reaction (jumpiness) for a few months, majority recover

Paranoid ideation and hypervigilance

DSM eight criteria: exposure to actual or threatened death, serious injury, or sexual violation.

Direct experience or witnessing or learning that this has happened to a loved one, recurrent exposure to details of the event

Flashbacks, avoidance of internal and external trigger/stimuli, negative alterations in cognitions and moods associated with the event (e.g. guilt or blame, estrangement, anhedonia, constriction, dissociation), alterations in arousal and reactivity (aggressive, reckless, or self-destructive behavior).

Effects on functioning (social settings, workplace).

Culture influences symptoms: somatic or emotional.

High prevalence of comorbidities such as depression and substance abuse (SUD: Substance Use Disorder).

Re-experiencing: flashbacks, intrusive memories, dreams, distress

Avoidance also includes defensive withdrawal from distressing memories, thoughts, feelings as well as external reminders (triggers).

PTSD higher among young, women, minorities, and people with comorbidities (preexisting conditions), poor psychosocial resources (e.g., in developing countries).

Threshold PTSD (50-90%) much more common than PTSD (10-30%)

Rates are much reduced when there is a cohesive community response

PTSD more common in manmade (“evil”) traumatic events: terrorism, mass shootings, war, rape than in natural disasters. Still, COVID-19 sharply elevated stress and trauma related disorders (was perceived as manmade!!!)

Talk therapy (Prolonged Exposure, Cognitive Processing Therapy, EMDR, Brief Eclectic Therapy, Narrative Exposure Therapy, Written Narrative Exposure, virtual reality) superior to pharmacotherapy (SSRI but not antipsychotic) as first line treatment. Debriefing is counterindicated.

Acute Stress Disorder (ASD) precursor of PTSD. Requires PIES (Proximity, Immediacy, Expectancy, Simplicity).

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