Post Traumatic Stress
Disorder
By:
Gina Clark,
Leann Kuhlmann,
Hallie Silavent
Katie Paddon, &
Ashley Seyer
What is PTSD?
- a broad category that applies to people who have been
severely thraumatized at one or more times in their life
-at present, they are not functioning effectively because they
have not integrated the trauma and laid it to rest.
-PTSD is threathening to oneself and their loved ones
PTSD on the DSM
1.) The person has been exposed to a traumatic event in which
both of the following were present:
- The person experienced, witnessed, or was confronted
with an event(s) that involved
a.) actual or threatened death or serious injury
b.) or a threat to the physical integrity of self or others
-The person's response involved intense fear,
helplessness, or horror.
DSM continued...
2.) The traumatic event is persistently reexperienced in one or
more of the following ways:
- recurrent & intrusive distressing recollections of the event
(includes images, thoughts, perceptions)
- recurrent distressing dreams of the event
-Acting or feelings as if the traumatic event were recurring
(illusions, hallucinations, flashbacks, etc.)
- Intense psychological distress at exposure to
internal/external cues that symbolize/resemble an aspect of the
traumatic event
- Physiological reactivity of an aspect of the traumatic
event
3.) Persistent avoidance of stimuli associated with the trauma &
numbing of general reponsiveness (3 or more of the following)
-efforts to aviod thoughts, feelings, convos associated with
the trauma
-efforts to aviod activities, places, or people that arouse
the recollection of the trauma
-inability to recall an important aspect of the trauma
-markedly diminished interest/participation in significant
activities
-feelings of detachment/estrangement from others
-restricted range of affects (inability to feel love, trust...)
-sence of foreshortened future (can't see life w/o job,
normal relationship, ever having kids, normal life, etc...)
4.) Persistent symptoms of increased arousal as indicated by
two or more of the following:
-difficulty falling or staying asleep
-irritability or outbursts of anger
-difficulty concentrating
-hypervigilance
-exaggerated startle response
5.) Duration of the disturbance (symptoms in criteria 2-4) for 1
month or longer
6.) The disturbance causes clinically significant distress or
impairment in social, occupational, or other important areas of
functioning.
Acute Stress Disorder
-A psychological condition arising in response to a terrifying
event. (aka: psychological shock)
-Results from physical/mental stress, fear, or
pain in accordance with/from PTSD, usually subsides within a
few hours or even days
-symptoms include: initial state of "daze", inability to
comprehend imformation, low attention, & agitation.
DSM criteria for Acute Stress Disorder
1.) The person has been exposed to a traumatic event in which
both of the following were present:
- The person experienced, witnessed, or was confronted
with an event(s) that involved
a.) actual or threatened death or serious injury
b.) or a threat to the physical integrity of self or others
-The person's response involved intense fear,
helplessness, or horror.
2.) Either while exeriencing or after experiencing a distressing
event, the indivual has 3 (or more) of the following:
a.)a subjective sense of numbing, detachment, or absence
of emotional responsiveness
b.) a reduction in awareness of his/her surroundings
c.)derealization
d.)depersonalization
e.)dissociative amnesia(unable to recall important aspects
of trauma)
3.) Traumatic event is persistently re-experienced in at least 1
of the following way: recurrent dreams, images, thoughts,
flashbacks, ect. Reminding them of the traumatic event.
4.) Marked avoidance of stimuli that arouse recollecgtions of
the trauma (thoughts, feelings, convos, places, people, etc)
5.)Marked symptoms of anxiety or increased arousal(difficulty
sleeping, poor concentraction, hypervigilance, motor
restlessness, etc...)
6.) The disturbance causes clinically sigificant distress or
impairment in social, occupational, or other important areas of
functioning. Or impairs the individual's ability to persue some
necessary tasks, obtaining necessary assistance, or mobilizing
personal resources (telling family members about the trauma)
7.) The disturbance lasts for a minimum of 2 days & a
maximum of 4 weeks and occurs within 4 weeks after traumatic
event.
8.) The disturbance is not due to the direct phsiological effect of
a substance (drug abuse, or medication) or a general medical
condition
Serving in Combat
or
Living in a War Zone
• Counselors first became aware of PTSD dealing with war
veterans
• Average person dealing with PTSD (in the military)
• Possible symptoms
• Shell Shock
• The difference between WWII veterans and Vietnam
Veterans
• Acute stress disorder in the military & Persian Gulf Syndrom
Suffering Personal
or
Family Victimization
• People are often victimized by others who intend to kill,
harm, or itimidate, or all three
• Sexual abuse survivors constitue the largest number of
PTSD victims
• Many perpetrators of this type of victimization know their
victims personally
• Trust issues
Types of trauma that may lead to PTSD
• witnessing a loved one being murdered
• witnessing or being part of a gruesome car accident
• being kidnapped or being the parent of a child who is
abducted
• having personal property vandalized
• having ones home burglarized
• being robbed at gunpoint
PTSD for survivors of these types of trauma may be severe or
mild,depending on the perceived level of threat. They often
suffer from feelings of paranoia, hypervigilance, and
powerlessness. They are usually angry and fearful.
Natural and Manmade
Disasters
Life After Diaster: Concepts
• Material Resources
• Perception
o Blame
o Subjective Distress
• Danger and Opportunity
Phases
Heroic
Honeymoon
Disillusionment
Reconstruction
EFFECTS ON YOUNG CHILDREN
Effects on young children
(similar behavior to an abused child)
• returning to earlier behavior (thumb sucking or bed
wetting)
• clinging to parents
• being reluctant to go to bed
• nightmares
• fantasies that the disaster or incident never
happened
• screaming and crying
• withdrawal and becoming immobile
• refusing to attend school
• problems at school
• unable to concentrate
What can cause PTSD in children:
• survival of natural or manmade disaster (flood)
• violent crime (kidnapping, rape or murder of
parent, school shooting)
• car or plane crash
• severe burns
• war
• sexual and physical abuse
• peer suicide
• exposure to violence in community
PTSD effects on children
Very young children
• may show only a few symptoms because eight of
the symptoms require speech
• instead may show separation anxiety, avoid
situations that may or may not relate to the
trauma, trouble sleeping, repeat trauma during
play, regress by losing an acquired skill such as
potty training
PTSD effects on children
Elementary school-aged children
• may not experience flashbacks as adults do
• do experience time skew and omen formation,
which is not seen in adults
• time skew- mis-sequencing events when recalling
the memory of the trauma
• omen formation- belief that there were warning
signs predicting the trauma
• reenact trauma during play or in drawings
The Debriefing Process
Debriefing- intervention after a person has been
assessed to be affected by a critical incident; includes
listening, empathizing, educating, and supporting
• Traumatized people should be encouraged to function
where possible and maintain healthy eating habits and sleep
patterns
• Should attend community support groups, talking with others
who have shared the same trauma is beneficial
Interventions
When disaster happens:
• They affect not only those directly involved but
others who suddenly feel that their security is
threatened.
• Communites respond by providing support.
Examples of community
suppport include:
• Red Cross
• Elementary schools
• public parks
• local church organizations
The Importance of
the crisis worker
o Crisis
workers need to help people
to think differently about the crisis
situation
o The worker helps those experiencing
overwhelming feelings to focus
those feelings into productive
avenues for growth
Critical Incident &
Debriefing
Trama Response
• Special training programs developed for workers
wanting to help victims of disasters through the
Red Cross and other organizations such as the
International Medical Corps.
• A Crisis intervention method that stabilizes,
supports and normalizes peoples efforts to
strengthen coping abilities
• Prevent long-term damage such as PTSD,
substance abuse, depression, and family &
relationship problems.
• Not meant to be used as a "treatment"
Symptoms of PTSD
Physical symptoms include: fatigue, nausea, muscle tremors,
twitches, chest pain, difficulty breathing, elevated blood pressure,
rapid heart rate, thirst, visual difficulties, vomiting, grinding of
teeth, weakness, dizziness, profuse sweating, chills shock
symptoms, and fainting.
Emotional and behavioral symptoms include: anxiety, guilt, grief,
panic,fear, uncertainty, loss of emotional control, depression,
irritability, apprehension,change in activity, change in speech
patterns, withdrawal, outbursts, suspiciousness, loss or increase of
appetite, alcohol consumption, etc.
Symptoms of PTSD continued:
Cognitive symptoms include: blaming, confusion,
poor attention, poor decisions, poor concentration,
memory problems, increased or decreased awareness
of surroundings, poor abstract thinking, loss of time,
place, or person, nightmares, and intrusive images.