What Is Severe PTSD?

Post-traumatic stress disorder (PTSD) is caused by an individual experiencing, witnessing, or experiencing one or more actual deaths involving themselves or others, or threatened by death, or severely injured, or threatened by physical integrity Individuals have delayed appearance and persistent mental disorders. The incidence of PTSD has been mixed, and women are more likely to develop PTSD than men.

Basic Information

English name: posttraumatic stress disorder, PTSD
Visiting department: Psychiatry

Common symptoms: Traumatic reexperience symptoms, avoidance, numbness symptoms, increased alertness symptoms, symptoms of PTSD in children, etc.
Contagious: no

Causes of post-traumatic stress disorder

The occurrence of PTSD is related to many factors, which are mainly divided into family, psychosocial factors (such as gender, age, race, marital status, economic status, social status, work status, education level, stressful life events, personality Characteristics, defense style, childhood trauma, domestic violence, war, social support, etc.) and biological factors (such as genetic factors, neuroendocrine factors, neurobiochemical factors, etc.). Among them, major traumatic events are the basic conditions for the onset of PTSD, which is extremely unpredictable.

Clinical manifestations of post-traumatic stress disorder

The core symptoms of PTSD are three groups: traumatic reexperience symptoms, avoidance and numbness symptoms, and increased alertness symptoms. However, the clinical manifestations of children and adults are not exactly the same, and some symptoms are unique to children.

Traumatic reexperience symptoms

Mainly manifested in the patient's thinking, memory or dream repeatedly and involuntarily emerged from the trauma-related situation or content, can also have serious emotional reactions, and even feel the traumatic event as if it happened again.

2. Avoidance and numbness symptoms

It is mainly manifested in patients' long-term or persistent efforts to avoid events or situations related to traumatic experiences, to refuse to participate in related activities, to avoid locations or people or events related to trauma, and some patients even have selective forgetting and cannot recall Trauma related event details.

3. Symptoms of increased alertness

The main manifestations are excessive alertness, increased startle response, which may be accompanied by a lack of attention, increased irritability, and anxiety.

4. Other symptoms

Some patients may also exhibit abuse of addictive substances, aggressive behavior, self-injury or suicidal behavior, etc. These behaviors are often the manifestation of patients' psychological behavior coping styles. Depression is also a common symptom in many patients with PTSD.

5. Symptoms of PTSD in children

Children's traumatic re-experience symptoms can be manifested as nightmares, repeatedly playing traumatic events, playing themed games related to trauma, emotional excitement or sadness in the face of relevant prompts, and so on. Avoidance symptoms often appear in children as separation anxiety, Sticky people, unwilling to leave their parents; High alert symptoms often manifest in children with excessive startle response, high alertness, attention disorders, irritability or anger, difficulty falling asleep, etc. And children of different ages may have different PTSD performance.

Diagnosis of post-traumatic stress disorder

According to DSM-IV-TR, the diagnostic criteria of PTSD are as follows:

1. Standard A

The individual has been exposed to traumatic events that have both of the following: A1 The person experienced, witnessed, or encountered one or more actual deaths involving himself or others, or was threatened by death, or severely injured, or physically intact Sex is threatened. A2 The person's response includes strong fear, helplessness, or panic. Note: In children, it may appear as chaotic or irritating behavior.

2. Standard B

Traumatic events are continuously re-experienced in one (or more) of the following ways: B1 repetitive, intervening distressed memory of the event, including images, thoughts, or perceptions. Note: In young children, certain themes or aspects of traumatic events can occur in repetitive games. B2 repetitive distressed dreams about events. Note: In children, frightening dreams may occur, but there is no recognizable content. B3 behaves or feels as if traumatic events have reappeared (including re-experiencing traumatic experiences, illusions, hallucinations, dissociative flashback events, including occurrences of consciousness or poisoning). Note: Trauma-specific repetitions may occur in young children. B4 Strong psychological distress when exposed to certain aspects that are symbolic of or similar to certain aspects of traumatic events. B5 Physiological response when exposed to some aspect of a traumatic event or an internal or internal cues similar to that of a traumatic event.

3. Standard C

Make a lasting avoidance of the stimuli associated with this trauma, and the response to general things seems numb (this was not the case before the trauma), such as three or more of the following: C1 Efforts to avoid thoughts, feelings or dialogue related to trauma . C2 avoidance will evoke the activity, place or person who recalled the trauma. C3 cannot recall important aspects of this trauma. C4 's interest or participation in important activities has decreased significantly. C5 feeling of alienation and isolation from others. C6 is limited in emotion (such as being unable to have a feeling of love). C7 feeling of shortening in the future (such as not expecting a career, marriage, children, or normal life).

4. Standard D

Symptoms of increased alertness (not present before trauma) are manifested as two or more of the following: D1 has difficulty falling asleep, or has difficulty sleeping. D2 is irritating or irritable. D3 has difficulty concentrating. D4 is overly alert. D5 Excessive startle response.

5. Standard E

These disorders (symptoms of B, C, and D) lasted longer than 1 month.

6. Standard F

These disorders cause clinically significant distress or impaired social, professional or other important functions.

Post-traumatic stress disorder treatment

According to current evidence-based medicine, psychotherapy is the most effective way to cure PTSD. Commonly used psychotherapy for PTSD includes cognitive behavioral therapy, hypnosis therapy, reprocessing of eye movement desensitization, and psychoanalytic therapy. Drug treatment is effective in alleviating the symptoms of patients and strengthening psychological treatment. The combined use of the two should be the first choice. The currently preferred treatment drugs are SSRIs. Among them, sertraline, paroxetine, and fluoxetine have better Efficacy.

Prevention of post-traumatic stress disorder

PTSD usually develops within a few days to six months after the occurrence of a traumatic event. The course of the disease lasts for at least one month, can last for months or years, and can even last for decades. Acute PTSD is called within 3 months, and chronic PTSD is called after 3 months, and delayed PTSD occurs if symptoms occur at least 6 months after the traumatic event. If some psychological assessment tools can be used to preliminary assess the individual's mental health after the traumatic event, it will help to screen out the high-risk population of PTSD and provide effective intervention strategies to the high-risk population.