Text Box: Post Traumatic Stress Disorder
Post Traumatic Stress Disorder or PTSD has affected many people over the course of history. Research has shown that soldiers as early as 900-1000 AD reported symptoms commonly found now. During the Civil War it was called DeCosta’a Syndrome. During the World Wars it was referred to as battle fatigue or shell shock. The long tem effects and reality did not become a point of research and treatment until the Vietnam era. And not until the 1980’s did the disorder receive specific diagnostic criteria and placement in the Diagnostic and Statistical Manual. Listed are abbreviated criteria to have a diagnosis of PTSD:
Criterion A: stressor
The person has been exposed to a traumatic event in which BOTH of the following have been present:
1. The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
2. The person's response involved intense fear, helplessness, or horror. Note: in children, it may be expressed instead by disorganized or agitated behavior.
Criterion B: intrusive recollection
The traumatic event is persistently re-experienced in at least one of the following ways: 
1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed. 
2. Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content. 
3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: in children, trauma-specific reenactment may occur. 
4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. 
5. Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
Criterion C: avoidant/numbing
Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:
Efforts to avoid thoughts, feelings, or conversations associated with the trauma, 
2. Efforts to avoid activities, places, or people that arouse recollections of the trauma, 
3. Inability to recall an important aspect of the trauma, 
4. Markedly diminished interest or participation in significant activities, 
5. Feeling of detachment or estrangement from others, 
6. Restricted range of affect (e.g., unable to have loving feelings), 
7. Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
Criterion D: hyper-arousal
Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least two of the following: 
1. Difficulty falling or staying asleep, 
2. Irritability or outbursts of anger, 
3. Difficulty concentrating, 
4. Hyper-vigilance, 
5. Exaggerated startle response
   The person exhibiting these symptoms may have been a victim of a serious crime, sexual assault, a serious auto accident, combat or any other event where they felt their safety and well being was in jeopardy. Many refer to these as big “T” events. But what about the events that you as an individual experience that cause the same symptoms of PTSD but Criteria A is not met. Diagnosis of a serious illness, the sudden loss of a job and security or unexpected marital problems that have a major impact on the safety and well being on one partner or the children. Many refer to these as little “t” traumas and although the criteria for the PTSD diagnosis are not met, the reactions and symptoms are still real. 

   The study of PTSD has become very intense and focused due to the debilitating effects. Along with the obvious symptoms stated above, depression, alcohol and drug use and even suicide are common. Why do some suffer and others not? It is unclear and researchers believe it may be due to the intensity or duration; poor coping skills at the time of the event or a history of previous mental illness, drug or alcohol use. Whatever the reason treatment is imperative. Only a few treatments are recognized as effective. 

   Cognitive behavioral therapy, CBT, in which the thoughts and memories are addressed reformed and processed. EMDR, eye movement desensitization and both may be combined with medication. The events are believed to have such an impact that they are not processed and stored as normal daily events are and thus they are in a memory state that causes them to randomly appear or are triggered by sensations recognized by any of the senses. 

   This disorder can and will severely impact your daily life in work, school or relationships. Many symptoms may dissipate over time but many may lay dormant until triggered by a place, smell or event. Education, therapy and support are the key components to healing. The process of healing and addressing the specific events may be scary and painful, however to achieve long term resolution the events leading to the symptoms should be addressed to avoid further decline, fear or isolation. 
Text Box: July Thought of the Month

July 2009

Issue 8

Carolina Center for Counseling

& Behavioral Interventions, LLC

Contact Information

304 A North East Main Street

  Simpsonville, SC 29681    


Phone: 864 - 963 - 4028

Fax: 877-201-4878


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