7.10.2008

THE POST TRAUMATIC STREES DISORDER



Definition of the Post Traumatic Stress Disorder (PTSD)


At least 1/3 individuals who have been exposed to traumatic events develop long term problems. These problems (unexplained somatic complaints, anxiety, depeated consultations.

A traumatic event could be natural disasters (earthquake, hurricane, or rape, war or armed conflict. A traumatic event breaks off a normal life. It is extremely powerful, potentially harmful and outside the scope of the normal life events. These events could be episodic of repetitive, those are so everwhelming that one's basic consepts of safety, security, and basic turst, moral, ethnics and future perspective are shattered. The prevalence of mass traumatisation is often associated with cycles of violence.

A normal reaction or coping prosess is necessary to integrate the traumatic experience. During the coping process both mental and physical traumatic stress symptoms are prevalent. Although these symptoms are a part of a normal reaction to abnormal events the victims perceived them as threatening. The healing (or coping) process is negatively influenced by the contex of disruption.

Intensity and Frequency
If healing or integration of the traumatic event fails (for example, in the case of repetition of the event), a post trumatic stress disorders or other psychopathology (mood, anxiety, behavioral disorders and psychosis) may develop.

PTSD includes both psychological and physical symptoms that persist more than 1 month after the traumatic event. Otherwise, it will be an acute stress disorder, relatively normal after a traumatic event.

Although a great similaity predominates between the signs of traumatic stress and PTSD there is an essential difference in intensity and frequency. People suffering from PTSD are stuck in their symptoms, while the signs of traumatic stress are still considered as a "normal reaction to abnormal circumstances".

The person's respone currently involved intense fea, helplessness or horror. In children, they may express that bay disorganized or agitated behavior.

The are three groups of Symptoms Intruction or recurent distressing recollection
  • Intrusive images or thoughts linked to the traumatic event despite efforts to block them out. In young children, repetitive play may occur in which themes or aspects of the truma are expressed.
  • Recurrent distressing dreams linked to the traumatic event or nightmares. In children, there may be frightening dreams without recognized content.
  • Flashback episodes during which the patient feels as he relives part of the traumatic event. In young children, trauma-specific reenactment may occur.
Avoidance
  • The patient tries to avoid everything that might be associated with the trauma (places, situations, people that arouse recollections of the trauma), avoidance of conversations, feelings or thoughts related to the trauma
  • Inability to recall an improtant aspect of the trauma
  • Having thoughts about the trauma : alcohol, psychotropic drugs or toxic drugs may be used for this purpose.
Increased arousal
  • Anxiety
  • Insomnia, difficulty falling or staying asleep (these symptoms are important because if the patient doest't sleep well, he will spend his time to think on the traumatic event and his thoughts won't help him to sleep, so it may risk to fall in an infernal circle, with a body and mind tiredness)
  • Exaggerated startle response, panic attacks, hypervigilance
  • Sometimes hypertension, sweating, trembling tachycardia, headache etc.
Other Symptoms Behavioral
  • Avoidance of social and family relationships (feeling of detachment or estrangement from others).
  • Markedly diminished interest and participation in ususal activities.
  • Drugs and alcohol use.
Affective
  • Sadness, hopelessness, apathy
  • Irritability, difficulty controlling emotions, outbursts of anger.
  • Restricted range of affect (unable to have loving feelings)
  • Feelings of misunderstood
  • Sense of foreshortened future.
Sources : WHO, Health Massenger, http://nlm.nih.gov, MsF-Holland guideline

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