Training Program

In
Clinical Psychology
 Day 11
Psychopathology 7
PTSD (POST TRAUMATIC STRESS
DISORDER)
The diagnosis of PTSD first entered the
DSM in 1980. At this time, psychiatry began
to realize that many veterans were
emotionally scarred and unable to return to
normal civilian life after their military
service.

Stress symptoms are very common in the

immediate aftermath of a traumatic event.
However, for most people, these symptoms
decrease with time.

Let's watch a video

SYMPTOMS
A. Exposure to actual or threatened death, serious injury, or sexual violence

B. Presence of symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred.

C. Persistent avoidance of stimuli associated with the traumatic event(s)

D. Negative alterations in cognitions and mood associated with the traumatic event(s)

E. Marked alterations in arousal and reactivity associated with the traumatic event(s)

The diagnosis of PTSD requires that symptoms must last for at least 1 month.

The criteria apply to adults, adolescents, and children older than 6 years.
ACUTE STRESS DISORDER
Acute stress disorder is a diagnostic category that can be used when symptoms develop shortly after
experiencing a traumatic event and last for at least 2 days. The existence of this diagnosis means that people
with symptoms do not have to wait a whole month to be diagnosed with PTSD. Instead they can receive
treatment as soon as they experience symptoms.

Moreover, if symptoms persist beyond 4 weeks, the diagnosis can be changed from acute stress disorder to
posttraumatic stress disorder. Studies show that people who develop an acute stress disorder shortly after a
traumatic event are indeed at increased risk of developing PTSD.
Causes:

1. Biological Factors Given that PTSD is a stress disorder, it might be expected that people with this disorder
would have high levels of stress hormones such as cortisol. However, this does not generally seem to be the
case always.

2. Sociocultural Factors: Traumatic event, Discrimination, Racism etc.

Treatment for Stress Disorders:

1. Telephone Hotlines

2. Crisis Intervention

3. Psychotherapy : CBT, REBT, other therapeutic techniques

4. Medication
SOMATIC SYMPTOM DISORDER
The somatic symptom disorders lie at the interface between abnormal psychology and medicine. They are a
group of conditions that involve physical symptoms combined with abnormal thoughts, feelings, and
behaviors in response to those symptoms (APA, 2013).

Soma means “body,” and somatic symptom disorders involve patterns in which individuals complain of
bodily symptoms that suggest the presence of medical problems but where there is no obvious medical
explanation that can satisfactorily explain the symptoms
DSM-5 is on there being at least one of the following three features:

(1) disproportionate and persistent thoughts about the seriousness of one’s symptoms;

(2) persistently high level of anxiety about health or symptoms; and/or

(3) excessive time and energy devoted to these symptoms or health concerns

- Symptoms have to have persisted for at least six months.

- Patients with somatic symptom disorder are usually seen in medical clinics.

Causes:

Research suggests that people with somatic symptom disorders tend to have a cognitive style that leads them to be
hypersensitive to their bodily sensations.
Case Discussion
Paul is a 27-year-old man who comes to you for help at the urging of his fiancée. He was an infantryman with
a local Marine Reserve unit who was discharged in 2014 after serving two tours of duty in Iraq. His fiancé has
told him he has “not been the same” since his second tour oty and it is impacting their relationship. Although
he offers few details, upon questioning he reports that he has significant difficulty sleeping, that he “sleeps
with one eye open” and, on the occasions when he falls into a deeper sleep, he has nightmares. He endorses
experiencing several traumatic events during his second tour, but is unwilling to provide specific details – he
tells you he has never spoken with anyone about them and he is not sure he ever will.

He spends much of his time alone because he feels irritable and doesn’t want to snap at people. He reports to
you that he finds it difficult to perform his duties as a security guard because it is boring and gives him too
much time to think. At the same time, he is easily startled by noise and motion and spends excessive time
searching for threats that are never confirmed both when on duty and at home. He describes having intrusive
memories about his traumatic experiences on a daily basis but he declines to share any details. He also avoids
seeing friends from his Reserve unit because seeing them reminds him of experiences that he does not want to
remember.
Any Questions???