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DR. Attiya Asghar Khan
Submited by
Maryam Shahzadi
MSCP02203051
Presentation
PTSD is a disorder that develops in
some people who have experienced
a shocking, scary, or dangerous
event.
PTSD is a set of reaction that can
occur after someone has been
through a traumatic event.
PTSD is a anxiety disorder caused
by very stressful, frightening and
distressing events.
Diagnostic Criteria
A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of
the following ways:
1. Directly experiencing the traumatic events.
2. Witnessing, in person, the events as it occurred to others.
3. Learning that the traumatic events occurred to a close family member or close friend. In cases
of actual or threatened death of a family member or friend, the event(s) must have been violent
or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g.,
first responders collecting human remains: police officers repeatedly exposed to details of child
abuse).
The following criteria apply to adults, adolescents, and children older than 6 years.
1. Recurrent, involuntary, and intrusive distressing memories of
the traumatic event(s).
2. Recurrent distressing dreams in which the content and/or
affect of the dream are related to the traumatic event.
3. Dissociative reactions (e.g., flashbacks) in which the
individual feels or acts as if the traumatic events were recurring.
4. Intense or prolonged psychological distress at exposure to
internal or external cues that symbolize or resemble an aspect
of the traumatic event.
5. Marked physiological reactions to internal or external cues
that symbolize or resemble an aspect of the traumatic events.
B. Presence of one (or more) of the following intrusion symptoms associated with the
traumatic event(s), beginning after the traumatic events occurred;
1. Avoidance of or efforts to avoid distressing
memories, thoughts, or feelings about or closely
associated with the traumatic event(s).
2. Avoidance of or efforts to avoid external
reminders (people, places, conversations,
activities, objects, situations) that arouse
distressing memories, thoughts, or feelings about
or closely associated with the traumatic event(s).
C. Persistent avoidance of stimuli associated with the traumatic event(s),
beginning after the traumatic event(s) occurred, as evidenced by one or both of
the following:
1. Inability to remember an important aspect of
the traumatic event(s) (typically due to
dissociative amnesia and not to other factors
such as head injury, alcohol, or drugs).
2. Persistent and exaggerated negative beliefs or
expectations about oneself, others, or the world.
. 3. Persistent, distorted cognitions about the
cause or consequences of the traumatic event(s)
that lead the individual to blame himself/herself
or others.
4. Persistent negative emotional state (e.g., fear,
horror, anger, guilt, or shame).
5. Markedly diminished interest or participation
in significant activities.
6. Feelings of detachment or estrangement from
others.
7. Persistent inability to experience positive
emotions (e.g., inability to experience happiness,
satisfaction, or loving feelings).
D. Negative alterations in cognitions and mood associated with the traumatic event(s),
beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more)
of the following:
1. Irritable behavior and angry outbursts (with little or no provocation)
typically expressed as verbal or physical aggression toward people or
objects.
2. Reckless or self-destructive behavior.
3. Hypervigilance.
4. Exaggerated startle response.
5. Problems with concentration
. 6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless
sleep).
E. Marked alterations in arousal and reactivity associated with the traumatic event(s),
beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or
more) of the following:
F. Duration of the disturbance (Criteria B, C,
D, and E) is more than 1 month.
G. The disturbance causes clinically
significant distress or impairment in social,
occupational, or other important areas of
functioning.
H. The disturbance is not attributable to the
physiological effects of a substance or another
medical condition.
Posttraumatic Stress Disorder for Children 6 Years and Younger
A. In children 6 years and younger, exposure to actual or threatened death, serious
injury, or sexual violence in one (or more) of the following ways
1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it occurred to others, especially primary caregivers.
3. Learning that the traumatic event(s) occurred to a parent or caregiver.
1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the
traumatic event(s).
3. Dissociative reactions (e.g., flashbacks) in which the child feels or acts as if the traumatic
event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme
expression being a complete loss of awareness of present surroundings.) Such trauma-specific
reenactment may occur in play.
• 4. Intense or prolonged psychological distress at exposure to internal or external cues that
symbolize or resemble an aspect of the traumatic event(s).
5. Marked physiological reactions to reminders of the traumatic event(s).
B. Presence of one (or more) of the following intrusion symptoms associated with
the traumatic event(s), beginning after the traumatic event(s) occurred:
C. One (or more) of the following symptoms, representing either persistent avoidance of stimuli
associated with the traumatic event(s) or negative alterations in cognitions and mood associated
with the traumatic event(s), must be present, beginning after the event(s) or worsening after
the event(s):
Persistent Avoidance of Stimuli
1. Avoidance of or efforts to avoid activities, places, or physical reminders that arouse
recollections of the traumatic event(s).
2. Avoidance of or efforts to avoid people, conversations, or interpersonal situations that
arouse recollections of the traumatic event(s).
Negative Alterations in Cognitions
3. Substantially increased frequency of negative emotional states (e.g., fear, guilt, sadness,
shame, confusion).
4. Markedly diminished interest or participation in significant activities, including constriction of
play.
5. Socially withdrawn behavior.
6. Persistent reduction in expression of positive emotions
D. Alterations in arousal and reactivity associated with the traumatic event(s), beginning or
worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the
following:
1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as
verbal or physical aggression toward people or objects (including extreme temper tantrums).
2. Hypervigilance.
3. Exaggerated startle response.
4. Problems with concentration.
5. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
E. The duration of the disturbance is more
than 1 month.
F. The disturbance causes clinically
significant distress or impairment in
relationships with parents, siblings, peers,
or other caregivers or with school behavior.
G. The disturbance is not attributable to the
physiological effects of a substance (e.g.,
medication or alcohol) or another medical
condition.
Signs
Headache,
Fainting
Agitation
Dizziness
Chest Pain
anxiety
nervousness
forgetfulnes
inability to
experience
pleasure
lack of
motivation.
feeling slowed
down or speeded
up.
being uncaring.
avoiding others or
isolating.
•Effort to avoid thoughts
•Avoid activities
•Feeling flat
•Sense of shortened
•Future
•Flashbacks
•Difficulty with sleep
•Irritability
•Outbursts of anger
•Difficulty concentrating
•Exaggerated startle
response
•Thoughts distortion
•Nightmares
•Guilt
•Poor memory
•Feeling
detached
•Stress
•Irritability
•Isolation
•Insomnia
•Communication
problem
•Poor judgment
•Anxiety
•Avoidance
•Poor self
esteem
•Negative self
image
•Helplessness
•Depression
•Apathy
•Ulcers
•Physical pain
•Mistrust
•Rage
•Frustration
Symptoms
•Abuse • Mental • Physical • Sexual • Verbal
(i.e., sexual and/or violent content) •
Catastrophe • Harmful and fatal accidents •
Natural disasters • Terrorism • Violent attack •
Animal attack • Assault • Battery and
domestic violence • Rape • War, battle, and
combat • Death • Explosion • Gunfire
Causes PTSD
Least 6 months have passed between the
traumatic event and the onset of the symptoms.
Types of PTSD
1: Acute.
The duration of symptoms is less than 3
months
The symptoms last 3 months or longer.
2:Chronic
3:Delayed Onset
Risks and factors
Differential Diagnosis
Adjustment disorders
Other post traumatic disorder and
conditions
Acute stress disorders
(3 days to 1 month)
Anxiety disorders and obsessive
compulsive disorders
Major depressive disorders
Personality disorders
Dissociative disorders
Conversion disorders
Psychotic disorders
Traumatic brain injury
Individuals with PTSD are 80% more likely than those without
PTSD to have symptoms that meet diagnostic criteria for at least one
other mental disorder (e.g., depressive, bipolar, anxiety, or substance
use disorders). Comorbid substance use disorder and conduct
disorder are more common among males than among females.
Comorbidity
Post Traumatic stress disorder

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Post Traumatic stress disorder

  • 1. DR. Attiya Asghar Khan Submited by Maryam Shahzadi MSCP02203051 Presentation
  • 2. PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. PTSD is a set of reaction that can occur after someone has been through a traumatic event. PTSD is a anxiety disorder caused by very stressful, frightening and distressing events.
  • 3. Diagnostic Criteria A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways: 1. Directly experiencing the traumatic events. 2. Witnessing, in person, the events as it occurred to others. 3. Learning that the traumatic events occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental. 4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains: police officers repeatedly exposed to details of child abuse). The following criteria apply to adults, adolescents, and children older than 6 years.
  • 4. 1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). 2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event. 3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic events were recurring. 4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. 5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic events. B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic events occurred;
  • 5. 1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). 2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:
  • 6. 1. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). 2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world. . 3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. 4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). 5. Markedly diminished interest or participation in significant activities. 6. Feelings of detachment or estrangement from others. 7. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings). D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
  • 7. 1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. 2. Reckless or self-destructive behavior. 3. Hypervigilance. 4. Exaggerated startle response. 5. Problems with concentration . 6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
  • 8. F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. H. The disturbance is not attributable to the physiological effects of a substance or another medical condition.
  • 9. Posttraumatic Stress Disorder for Children 6 Years and Younger A. In children 6 years and younger, exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways 1. Directly experiencing the traumatic event(s). 2. Witnessing, in person, the event(s) as it occurred to others, especially primary caregivers. 3. Learning that the traumatic event(s) occurred to a parent or caregiver. 1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). 2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). 3. Dissociative reactions (e.g., flashbacks) in which the child feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Such trauma-specific reenactment may occur in play. • 4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). 5. Marked physiological reactions to reminders of the traumatic event(s). B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:
  • 10. C. One (or more) of the following symptoms, representing either persistent avoidance of stimuli associated with the traumatic event(s) or negative alterations in cognitions and mood associated with the traumatic event(s), must be present, beginning after the event(s) or worsening after the event(s): Persistent Avoidance of Stimuli 1. Avoidance of or efforts to avoid activities, places, or physical reminders that arouse recollections of the traumatic event(s). 2. Avoidance of or efforts to avoid people, conversations, or interpersonal situations that arouse recollections of the traumatic event(s). Negative Alterations in Cognitions 3. Substantially increased frequency of negative emotional states (e.g., fear, guilt, sadness, shame, confusion). 4. Markedly diminished interest or participation in significant activities, including constriction of play. 5. Socially withdrawn behavior. 6. Persistent reduction in expression of positive emotions D. Alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: 1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects (including extreme temper tantrums). 2. Hypervigilance. 3. Exaggerated startle response. 4. Problems with concentration. 5. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
  • 11. E. The duration of the disturbance is more than 1 month. F. The disturbance causes clinically significant distress or impairment in relationships with parents, siblings, peers, or other caregivers or with school behavior. G. The disturbance is not attributable to the physiological effects of a substance (e.g., medication or alcohol) or another medical condition.
  • 12. Signs Headache, Fainting Agitation Dizziness Chest Pain anxiety nervousness forgetfulnes inability to experience pleasure lack of motivation. feeling slowed down or speeded up. being uncaring. avoiding others or isolating.
  • 13. •Effort to avoid thoughts •Avoid activities •Feeling flat •Sense of shortened •Future •Flashbacks •Difficulty with sleep •Irritability •Outbursts of anger •Difficulty concentrating •Exaggerated startle response •Thoughts distortion •Nightmares •Guilt •Poor memory •Feeling detached •Stress •Irritability •Isolation •Insomnia •Communication problem •Poor judgment •Anxiety •Avoidance •Poor self esteem •Negative self image •Helplessness •Depression •Apathy •Ulcers •Physical pain •Mistrust •Rage •Frustration Symptoms
  • 14. •Abuse • Mental • Physical • Sexual • Verbal (i.e., sexual and/or violent content) • Catastrophe • Harmful and fatal accidents • Natural disasters • Terrorism • Violent attack • Animal attack • Assault • Battery and domestic violence • Rape • War, battle, and combat • Death • Explosion • Gunfire Causes PTSD
  • 15. Least 6 months have passed between the traumatic event and the onset of the symptoms. Types of PTSD 1: Acute. The duration of symptoms is less than 3 months The symptoms last 3 months or longer. 2:Chronic 3:Delayed Onset
  • 17. Differential Diagnosis Adjustment disorders Other post traumatic disorder and conditions Acute stress disorders (3 days to 1 month) Anxiety disorders and obsessive compulsive disorders Major depressive disorders Personality disorders Dissociative disorders Conversion disorders Psychotic disorders Traumatic brain injury
  • 18. Individuals with PTSD are 80% more likely than those without PTSD to have symptoms that meet diagnostic criteria for at least one other mental disorder (e.g., depressive, bipolar, anxiety, or substance use disorders). Comorbid substance use disorder and conduct disorder are more common among males than among females. Comorbidity

Editor's Notes

  1. Post traumatic stress disorder