Post-Traumatic Stress Disorder (PTSD)

While a wide variety of experiences may be described as "traumatic", in order to meet the criteria for PTSD, a person must have experienced or witnessed an event or events that involved actual or threatened death or serious injury accompanied by feelings of intense fear, helplessness, or horror.

Following the trauma, the person experiences three types of symptoms:

  • re-experiencing the event through vivid memories, dreams or flashbacks
  • numbed responsiveness and avoidance of stimuli associated with the event
  • physiological hyperarousal such as difficulty sleeping or concentrating, hypervigilance, anger and irritability, or an exaggerated startle response.

The DSM-IV criteria for PTSD are very specific, and like any disorder, it can only be diagnosed by a professional with expertise in diagnosing and treating anxiety disorders.

There has been a great deal of research on PTSD, mostly focused on rape victims and Vietnam veterans. Studies suggest that because memories and other cues related to the trauma trigger intense anxiety, these thoughts and cues are actively avoided. This prevents the habituation to these cues that would naturally occur through successive exposure. For example, the person who is in a traumatic car accident may initially experience intense anxiety when they first begin to drive again. With repeated exposure to driving, this fear response diminishes over time. If the person avoids driving, or even avoids being near cars following the trauma, there is no opportunity for the anxiety to subside, and it may remain quite intense even if the person is not in another accident. For this reason, cognitive-behavioral therapy and acceptance and commitment therapy both emphasize the importance of some type of exposure as a component of any treatment plan for PTSD.