Associated Problems
PTSD is often accompanied by other physical and
psychological problems and a comorbid diagnosis
may be warranted. Common associated problems
in PTSD include:
● Feelings of panic and other anxiety reactions
● Depression and dysphoric mood
● Abuse of alcohol or other drugs in an attempt
to ‘self-medicate’ and blunt the painful
memories
Barriers to Diagnosing PTSD
Effective management begins with a thorough
assessment of the person's problems. However,
this is often difficult due to:
● Reluctance to talk about unpleasant events and
sensations
● Embarrassment at admitting symptoms
● Overlap with other problems, especially
depression, anxiety and substance abuse
● Failure of clinicians to acknowledge traumatic
stress or ask the right questions
Screening for PTSD
The following questions may be useful in
screening for full or partial PTSD:
● Are you troubled by any vivid memories or
unwanted dreams?
● Do you avoid things which remind you of any
event from the past?
●
Do you at times feel emotionally numb?
Are you irritable or constantly on edge?
Posttraumatic
It is important also to enquire about associated
problems.The following questions are useful:
Stress Disorder
● Have you been consuming a large amount of food,
drink or drugs lately?
● How has your mood been?
● Are your relationships unusually troubled? INFORMATION FOR
HEALTH CARE PROFESSIONALS
It is particularly important to establish the impact on
social and occupational functioning, since those
problems are likely to precipitate further
deterioration.
Diagnosis &
Remember that, even if it is present, PTSD may not Assessment
be the most pressing problem for the person. It is
important to prioritise and plan an intervention that
is tailored specifically for the needs of the individual. No 3 in the PTSD series of
Australian Centre brochures
To find out more about PTSD, other veteran
and military mental health issues or the
Australian Centre, please contact us at:
AUSTRALIAN CENTRE FOR POSTTRAUMATIC
MENTAL HEALTH (INC.)
A&RMC, 300 Waterdale Road, Heidelberg Heights
3081 AUSTRALIA.
Telephone: (03) 9496 2922
Facsimile: (03) 9496 2830
Email: acpmh-info@unimelb.edu.au
WebSite: www.acpmh.unimelb.edu.au

What is PTSD?
STRESS DISORDER
P OSTTRAUMATIC
(PTSD) is a psychological response
to the experience of overwhelming
traumatic events. It can affect people of
any age, culture or gender. PTSD can
result from many types of trauma,
especially those which threaten life.
PTSD has been known since ancient times, often by
other names such as war neurosis, shell shock and
rape trauma syndrome.
Traumatic stress can be seen as part of a normal
human response to overwhelming experiences. In
the majority of people, symptoms disappear over
the first few weeks or months with the help of
caring family members and friends. However, it is
common for the symptoms to vary in their
intensity over time. In some cases, they may not
appear for months, or even years, after trauma.
In some people, the symptoms are more severe
and can persist for many years. Such cases may
warrant a formal diagnosis of PTSD. Chronic PTSD
is not a "normal" response to trauma and develops
only in a relatively small proportion of trauma
survivors. However, many survivors continue to
be distressed by occasional memories. Partial
PTSD, characterised by intrusive and arousal
symptoms, is much more common.
The Symptoms of PTSD
PTSD is characterised by three interacting
groups of symptoms; intrusive, avoidance and
hyperarousal phenomena.
INTRUSIVE SYMPTOMS
Traumatic events are typically re-experienced as
"intruding" into the lives of PTSD sufferers.
The DSM-IV lists five intrusive symptoms. One is
required for a PTSD diagnosis:
● Distressing memories of the event
● Distressing dreams of the event
● Acting or feeling as if the traumatic event were
recurring
● Intense psychological distress when reminded of
the event
● Physiological reactivity (eg. sweating, heart racing)
when reminded of the event
Intrusive symptoms are a key element of PTSD,
but are not sufficient for a diagnosis alone. Many
survivors have intrusive symptoms without meeting
criteria for full PTSD.
AVOIDANCE AND NUMBING
SYMPTOMS
Avoidance and numbing symptoms represent
attempts to block out unpleasant memories and
feelings.The DSM-IV lists seven symptoms.Three
are required for a PTSD diagnosis:
● Efforts to avoid thoughts, feelings or
conversations associated with the trauma
● Efforts to avoid activities, places or people
which arouse recollections of the trauma
●
●
Inability to recall an important aspect of the
trauma
Markedly diminished interest or participation in
significant activities
● Feelings of detachment from others
● Restricted range of affect and emotional
responsiveness
● Sense of a foreshortened future
This emotional restriction severely affects
interpersonal relationships. Sufferers often report
that they cannot feel emotions, even for those to
whom they are closest.
If distressed trauma survivors do not meet
PTSD criteria, it is most likely because they have
insufficient avoidance and numbing symptoms.
Preliminary evidence suggests that numbing
symptoms are poor prognostic indicators.
HYPERAROUSAL SYMPTOMS
Severe trauma can cause individuals to feel
constantly at risk, causing them to be "jumpy" and
always on guard.The DSM-IV lists five arousal
symptoms.Two are required for a PTSD diagnosis:
● Difficulty falling or staying asleep
● Irritability or outbursts of anger
● Difficulty concentrating
● Hypervigilance for signs of danger
● Exaggerated startle response