Introduction to Post-Traumatic Stress Disorder

Mark Dombeck, Ph.D. Updated: Jul 25th 2002

This topic center concerns mental and emotional problems people experience in the wake of 'trauma', where trauma is understood to refer to an event involving being a victim of or witness to atrocity, violence, true horror and/or the death of another or near death of ones self. Examples might include rape, murder, torture, accidents, terrorism, etc. DSM describes two trauma disorders: acute stress disorder, and posttraumatic stress disorder, both of which you may read about in the links to the left of this document. In a nutshell, acute stress disorder occurs in the time frame between just after exposure to a traumatic event to six months later, and posttraumatic stress beginning at the six month point and extending thereafter.

All forms of post-trauma response are typically characterized by the presence of three classes of symptoms. First, the post-trauma victim typically experiences intrusive memories of the traumatic event. Intrusive recollections may occur during waking hours or sleep (in the form of repetitive vivid recreation nightmares involving the trauma). Second, the post-trauma victim makes efforts to avoid exposure to anything that might cause them to recall the trauma they experienced. Third, the post-trauma victim typically shows an exaggerated startle response and heightened anxiety levels. As a result of these sorts of symptoms, experienced on a consistent basis day in and day out, PTSD (as posttraumatic stress is called) can be a very debilitating condition.

Not all trauma victims experience PTSD immediately after exposure to trauma. Some persons react quickly to traumatic exposure, while others appear to emerge from traumatic exposure unscathed, only to experience the sudden emergence of PTSD-type symptoms months or years later.

Post-trauma reactions such as PTSD and Acute Stress Disorder are classified in the DSM as members of the family of Anxiety Disorders. This is all right and good, as trauma disorders definitely involve heightened anxiety symptomology. However, unlike other anxiety disorders, trauma disorders also frequently may involve Dissociative symptomology. In its mildest form, dissociation involves 'spacing out' so that events that are occurring appear to be unreal. In more severe forms of dissociation, memory for events may be misplaced (as in amnesia), or a person may be so unnerved by what they have experienced that they take on another persona (in a fugue state; see the movie, "Nurse Betty" for an example). The most tenacious and difficult to treat forms of PTSD are sometimes those that have formed when a trauma victim was dissociative during his or her experience of the trauma.

There's lots more to say about trauma reactions, of course, but this will serve as an introduction.

You may also wish to check out the wonderful GiftFromWithin.org website which is filled with articles by mental health professionals who specialize in treating PTSD syndromes. In particular, we hope you'll check out the following articles available on GiftFromWithin:

PTSD_101 For Journalists by Frank Ochberg, MD
Healing from Shame Associated with Traumatic Events by Angie Panos, Ph.D.
Anniversary Reactions: A Survivor's Guide on How to Cope by Angie Panos, Ph.D.
Posttraumatic Therapy by Frank Ochberg, MD

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