139 Post-Traumatic Stress Disorder
Learning Objectives
By the end of this section, you will be able to:
- Describe the nature and symptoms of PTSD
- Identify the risk factors and protective factors linked to PTSD
- Identify and describe current treatment options for PTSD
In the following section, we will discuss Post-Traumatic Stress Disorder (PTSD), a term used to describe a set of fear and arousal-related symptoms tied to a specific traumatic event or events. In approaching this content, we acknowledge that some readers may have personal experience with these kinds of trauma, and may be negatively affected by this material.
If you, or someone you know, is dealing with PTSD, supports are available through Wellness Canada that may be helpful.
Originally, PTSD was identified in the military after combat exposure and was referred to as shell shock or combat neurosis, and was mainly diagnosed in male combat veterans. In Waiting for First Light, Canadian General Romeo Dallaire shares his continuing struggles with PTSD after witnessing atrocities during the genocide in Rwanda in 1993-94. As head of the United Nations peacekeeping force, his experience left a lasting impact on his mental health and led to his medical dismissal from the military several years later. He has devoted his life to mental health advocacy for veterans and fighting exploitation of child soldiers through the Dallaire Institute for Children, Peace, and Security at Dalhousie University. Although long recognized as a significant mental health concern, there is stigma surrounding PTSD in this population and effective treatments still remain inaccessible to many that need them.
The kinds of traumas that cause these symptoms vary widely and have the ability to affect anyone. It wasn’t until the late 1970’s that the broader medical community acknowledged that the same set of symptoms could be seen in people who experienced sexual assault, so the more general term post-traumatic stress disorder was developed to include other kinds of psychological trauma (Herman, 1997).
A Broader Definition of PTSD
According to the DSM-5, PTSD is diagnosed when an individual who has had a traumatic experience develops a set of fear and arousal related symptoms that last at least a month. The individual may have been present for the traumatic event as a victim or a witness, or they may have second hand exposure to the event from someone who was present.
The symptoms of PTSD fall into four categories: Intrusion, Avoidance, Negative alterations in cognition and mood, and Alterations in arousal and reactivity. Intrusion symptoms occur when the traumatic event is re-experienced through memories, nightmares, flashbacks, and emotional or physical reactivity after exposure to stimuli associated with the trauma. Flashbacks occur when the individual relives the event, as if it is currently happening and can last from a few seconds to several days (APA, 2013a). Avoidance occurs when the individual avoids stimuli o