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  What is Trauma?

Post-Trauma Response

Post-Trauma Responses, including Post-Traumatic Stress Disorder (PTSD), may occur after exposure to a very stressful event.  Events that lead to PTSD and other related stress disorders tend to include those typified by serious injury, illness, or threat of death personally or to those who you know or have contact with.

A traumatic event is generally something that is terribly frightening that leaves you feeling hopeless, helpless and out-of-control of the unfolding events.

In the course of one’s lifetime approximately 60% of men and 50% of women directly experience at least one significant traumatic event. Women are more at risk of exposure to childhood sexual abuse or a sexual assault later in life; while men are more inclined to experience physical violence, war combat, natural disaster, accident or to witness another’s serious injury or death.

The good news is that although exposure to trauma is fairly common only 7-8% of the general population is diagnosed with PTSD over the course of their life-time.

Women tend to be more vulnerable to the development of PTSD (approximately 10%) while only 5% of men exposed to trauma will develop PTSD. In the U.S. approximately 5.2 million adults will meet the diagnostic criterion for PTSD in any given year. This number represents only a small percentage of individuals who have experienced a trauma over the course of the same year. So although diagnosis of PTSD is relatively small compared to exposure those suffering from the aftermath of trauma but still managing to cope is quite a large number and requires care in order to lead to an optimal outcome for the individual.

The most common post-trauma struggles result in the development of particular symptoms as a result of exposure to trauma in which one's personal health and well-being is threatened. The stressor is often identified as one that may lead to one's death or injury or that of a person close to the individual (i.e., friend, family or colleague).

There are six criteria that need to be met in part or whole in order to establish Post-Traumatic Stress Disorder (PTSD) as a diagno­sis. The PTSD diagnosis is based on the following cri­teria from the DSM:

A1: personal involvement in a life or death event that is a threat to personal safety or that of friends, associates, or family;

A2: the person responds to the stressor with horror, helplessness, or great fear;

B:   re­current, intrusive mental re-experiencing of the trauma;

C:   avoidance of trauma related cues and emo­tional numbing;

D:   hyperarousal;

E:   PTSD must be present for longer than 1 month; and

F:   the symptoms must be significant enough to impair functioning of life skills (APA, 2000).

Other possible diagnoses to consider might include: Acute Stress Disorder; Gen­eralized Anxiety Disorder; Major Depressive Disor­der; Panic Disorder; Adjustment Disorder, Dissocia­tive Disorders or Dysthymia.

The wording of the diagnostic criterion for PTSD in the DSM-IV-TR recognizes that the individual's response to a traumatic event is equal in importance as the ob­jective evaluation of the event itself and the degree to which it might be determined to be traumatic. By tak­ing into account individual responses, we are able to begin to make sense of why some individuals become debilitated after experiencing a seemingly innocuous event while others can spend long periods of time in the midst of heinous trauma without developing nega­tive effects.

To recap, key post-trauma symptoms include:

  • Feelings of horror, helplessness or fear
  • Recurrent, intrusive re-experiencing of the trau­matic event (i.e., nightmares, flashbacks, intrusive memory replay)
  • Avoidance of any trauma-related cues (i.e., places, people or activities associated with the trauma or resulting in reminders of the trauma)
  • Anxious arousal (i.e., increase in heart rate and breathing, nervousness, fearfulness, agitation, easily ignited startle response)
  • Impairment of life skills (i.e., ability to socialize, work, attend school or manage family responsibilities)