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Introduction
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Posttraumatic stress disorder (PTSD) is a common psychiatric disorder that can result after an individual experiences to a very traumatic event. PTSD can affect cognition, mood, somatic experiences, and behavior, which often leads to chronic impairment and an elevated risk of comorbid psychiatric illnesses, including a higher susceptibility to suicide (Mann et al, 2024). PTSD can present as intrusive thoughts, flashbacks, and nightmares of past events, avoidance of trauma triggers, hypervigilance, and sleep disturbance, and can lead to severe social, occupational, and interpersonal dysfunction (Sareen, 2022).
Types and Prevalence (Sareen, 2022)
Various types of trauma can result in PTSD such as:
- Sexual relationship/interpersonal violence [33%] (e.g., rape, childhood sexual abuse, intimate partner violence)
- Interpersonal-network trauma [30%] (e.g., unexpected death or traumatic event of a loved one, life-threatening illness of a child)
- Interpersonal violence [12%] (e.g., childhood physical abuse or witnessing interpersonal violence, physical assault, or being threatened by violence)
- Exposure to organized violence [3%] (e.g., refugee, kidnapping, civilian in a war zone)
- Participation in organized violence [11%] (e.g., combat exposure, accidentally or purposefully caused death or serious injury)
- Life-threatening traumatic events [11%] (e.g., motor vehicle accident, natural disaster, or toxic chemical exposure)
- Medical illness [6.5%] (e.g., myocardial infarction, stroke, intensive care unit hospitalization, obstructive sleep apnea)
Signs and Symptoms (Sareen, 2022)
Patients with PTSD experience significant cognitive, affective, or behavioral symptoms in response to reminders or triggers of a traumatic event. These may include:
- Intrusion symptoms: “re-experiencing” symptoms such as unwanted thoughts, nightmares, or “flashbacks” of the traumatic event, typically associated with fear or panic that may occur spontaneously or may be triggered by a similar event
- Avoidance symptoms: avoidance of things that remind them of the traumatic event, such as thoughts, feelings, activities, people, or situations, that can result in an impairment in daily life functioning
- Negative cognition or mood: depression, negative mood changes (may be initial presenting symptoms in PTSD), decreased interest in work or social activities, an inability to connect with others; guilt about the traumatic event
- Arousal and reactivity changes: irritability or aggressive physical or verbal behaviors; reckless or self-destructive behaviors (e.g., substance abuse), reduced concentration, and insomnia
Dissociative subtype of PTSD is associated with higher levels of impairment, comorbidity, and suicide risk. Dissociative symptoms include:
- Depersonalization: feeling disconnected from one’s own body, lost, or in a daze
- Derealization: feeling that the world is not real; experiencing a dreamlike state
- Amnesia: inability to remember details of the traumatic event or a lack of awareness of situations