Traumatic events

Re-experiencing of traumatic event outside normal human experience with increased arousal and avoidance of stimuli associated with the trauma... 

Symptoms similar to PTSD but occur within 1 month of the traumatic event... 

Vrana, S. and Lauterbuch, D., Prevelance of traumatic events and post traumatic symptoms in college students. Journal of Traumatic Stress 7(2), 289-302, 1994. 

The terror of this experience with her father along with her mothers refusal to help her, forced young Cathy to dissociate from these events by creating an entirely new personality, to deal with her father. Traumatic events in one s life can create a repressed memory or a condition of shock so severe that the victim becomes incapable of living with it on their own. In O Brien s case she discovered her family s perverted and abusive sexual history during her upbringing, but since that was all she knew, the acceptance of ritual abuse was sadly became the norm. 

In PTSD, exposure to a traumatic event causes immediate intense fear, helplessness, or horror. 

Feeling that the traumatic event is recurring (e.g., dissociative flashbacks)... 

Another challenge of the biometric findings comes from examining the taxon s stability (Watson, 2003). Watson examined the stability of the taxon over a three month interval in a sample of undergraduates (N = 465) and found that the DES-T was significantly less stable than measures of personality. For example, the stability of Neuroticism in this study was r =. 83, while the stability of the DES-T was only r =. 62. Bayesian membership had even lower stability (r =. 32), and the dichotomously scored taxon was unstable (r =. 29). The lack of stability raises a question about whether the dissociation taxon is really a product of early traumatic events. In fact, these data imply that the taxon reflects a qualitatively distinct but transient dissociative reaction, rather than a stable pathological experience. 

The stress disorders, PTSD and acute stress disorder (ASD), occur in the after-math of exposure to traumatic events such as combat, violent crimes, natural... 

Post-traumatic Stress Disorder (PTSD). The same distinction holds true for PTSD. Reminders of the tranma (e.g., sexual intimacy for a rape survivor loud noises for a combat veteran) can trigger panic attacks. Furthermore, PTSD is associated with a variety of avoidant behaviors that can resemble agoraphobia. In the case of PTSD, the avoidance is specifically targeted at reminders of the trauma. For example, places or people who in some way cue memories of the traumatic event are avoided. As for agoraphobia, the avoidance tends to be less specific. It is any sitnation from which it would be difficult to escape should a panic attack occur that is avoided. 

The DSM-IV diagnostic criteria for PTSD (cf. Table 5.10) requires that the patient has been exposed to a traumatic stressor. In this context, the concept of traumatic stress is specifically defined as an event involving actual or threatened death or serious injury, or a threat to physical integrity. Such traumatic events include sexual abuse (e.g., rape, molestation), life-threatening accidents, interpersonal violence, natural disasters, and combat. 

A. Has been exposed to a traumatic event in which both of the following occurred ... 

Certain individuals are especially likely to experience, or to have already experienced, a traumatic event. Trauma exposure is more likely among military personnel or those working in emergency services, for example, police officers, firefighters, or emergency medical technicians. In addition, those who have recently emigrated from war zones or regions of civil unrest are likely to have been exposed to a traumatic event. 

Gender is another important risk factor for PTSD. Although men are more likely to experience a traumatic event, PTSD is at least twice as common among women. This apparent gender discrepancy, however, provides an opportunity to examine the manner in which varied risk factors might interact. The gender difference might be explained, at least in part, by the nature of the traumatic stressors that are more likely to be experienced by women. In particular, women are disproportionately victimized by sexual traumas, such as rape or childhood sexual abuse. Sexual traumas, in both men and women, are more likely to lead to the development of PTSD than other traumas such as natural disasters. 

With the notable exception of the Veteran s Administration (VA) hospital system, health care providers, both in primary care and mental health care, do a relatively poor job of identifying PTSD. There are two basic steps to diagnosing PTSD (1) determining that the patient has been exposed to a traumatic event, and (2) determining that the trauma-exposed patient is experiencing symptoms that fulfill diagnostic criteria for the disorder. 

Obsessive-Compulsive Disorder. The obsessions of OCD resemble the intrusive thoughts of PTSD. For those with OCD, however, these intrusive thoughts are not limited to recollections of a traumatic event. 

Specific Phobia. This diagnosis is appropriate when exposure to a traumatic event leads to a phobic avoidance of some specific reminder of the trauma in the absence of other PTSD symptoms. For example, a survivor of a terrible automobile accident might avoid driving on freeways or traveling in cars altogether. If such avoidance occurs in the absence of other PTSD symptoms, then a specific phobia, rather than PTSD, could indeed be diagnosed. 

Psychotic Disorders. Patient descriptions of flashback experiences occasionally resemble those of auditory or visual hallucinations. In addition, the numbing and affective restriction of PTSD can resemble the affective flattening of schizophrenia. Finally, some evidence indicates that those with chronic psychotic disorders such as schizophrenia are more vulnerable to trauma, creating the possibility of comorbid PTSD and psychosis. Flashbacks can be distinguished from hallucinations in that the sounds and visions described by a patient with PTSD during a flashback represent a reexperiencing of an earlier traumatic event. The content of the flashback, therefore, is either directly or indirectly tied to the trauma. 

By definition, most patients who suffer a serious TBI present to an emergency room in the immediate aftermath of the traumatic event. However, patients may also be brought to medical attention days or even weeks after an apparently mild head injury when the symptoms are delayed or so subtle that they initially escaped detection. In some instances, patients may even visit a clinic unaware that their psychiatric symptoms are attributable to a remote head injury. One extreme example is so-called dementia pugilistica that occurs after years of repeated minor TBIs over the course of a boxer s career. 

Data of animal experiments discussed in this chapter suggest a variety of potential pharmacological targets for the treatment of pathological anxiety (Fig. 1). As the occurrence of traumatic events is usually unpredictable, it seems more promising to interfere with consolidation than with acquisition processes. In this context, the sympatho-adrenergic and the hypothalamic-pituitary-adrenal system are of particular interest. Both noradrenaline and corticosterone/cortisol are known to facilitate memory consolidation, in par-... 

Low cortisol levels may impede the process of biologic recovery from stress, resulting in a cascade of alterations that lead to intrusive recollections of the event, avoidance of reminders of the event, and symptoms of hyperarousal. This failure may represent an alternative trajectory to the normal process of adaptation and recovery after a traumatic event. 

Development of characteristic symptoms following an extreme traumatic event Chronic excessive anxiety and worry about a number of events or activities Symptoms of anxiety that are judged to be a direct physiological consequence of a general medical conditions... 

Severe traumatic event that threatened death or serious harm... 

He, like others, had also been exposed to traumatic events, often in the shape of drug-related violence involving other predatory drug users, as well... 

Those young people who had witnessed traumatic events like overdoses cited these as powerful reasons not to use drugs themselves ... 

The cardinal features of PTSD include initial exposure to a traumatic event, with the subsequent development of three symptom clusters reexperiencing of the trauma, avoidance behavior, and hyperarousal. The DSM-IV (American Psychiatric Association, 1994) criteria state that the A-criterion for PTSD, traumatic exposure, involves experiencing, witnessing, or being confronted with an event that is life threatening or involves serious threat or injury to oneself or others. 

Breslau, N., Davis, G.C., Andreski, P., and Peterson, E. (1991) Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry 48 216—222. 

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