Posttraumatic stress disorder (PTSD) is an anxiety disorder that a person may develop after experiencing or witnessing an extreme, overwhelming traumatic event during which they felt intense fear, helplessness, or horror.

2. COMPILED BY:
Arman Ahmed Khan
Diksha Prakash
Nishant Raghav
Sheetal
Yukta Thapliyal

4. • Posttraumatic stress disorder (PTSD) is an anxiety
disorder that a person may develop after experiencing
or witnessing an extreme, overwhelming traumatic
event during which they felt intense fear, helplessness,
or horror.
• The dominant features of posttraumatic stress disorder
are emotional numbing, hyper-arousal, and re-
experiencing of the trauma.
• PTSD covers several different forms of abnormal,
pathological anxiety, fears, phobias and nervous
conditions that may come on suddenly or gradually
over a period of several years, and may impair or
prevent the pursuing of normal daily routines.

5. • The person has experienced, witnessed, or been confronted with an event
or events that involve actual or threatened death or serious injury, or a
threat to the physical integrity of oneself or others.
• The person’s response involved intense fear, helplessness, or horror.
• Acute PTSD - symptoms less than three months
• Chronic PTSD - symptoms more than three months
• Although symptoms usually begin within 3 months of exposure, a delayed
onset is possible months or even years after the event has occurred.

6. • Recurrent and intrusive distressing recollections of the event.
• Intense psychological distress at exposure to things that
symbolizes or resembles an aspect of the trauma, including
anniversaries thereof.
• Irritability or outburst of anger-irritability can progress to rage

7. • Efforts to avoid activities, places, people or situations
that arouse recollection of the trauma.
• Inability to recall an important aspect of the trauma
(psychological amnesia)
• Markedly diminish interest in significant activities and
feelings of detachment from others.

8. • There are no laboratory tests to detect PTSD. To diagnose PTSD, a
healthcare provider will consider the above symptoms together with
history of trauma. He or she will likely also use psychological
assessment tools to confirm the diagnosis and involve an appropriately
trained specialist
• Can occur at any age, including childhood, and can affect anyone.
• Individuals who have recently immigrated from areas of considerable
social unrest and civil conflict may have elevated rates of PTSD.
• No clear evidence that members of different ethnic or minority groups
are more or less susceptible than others.

9. • Military combat
• Violent personal assault (sexual assault, physical attack, robbery, mugging)
• Being kidnapped
• Being taken hostage
• Terrorist attack
• Torture
• Incarceration as a prisoner of war or in a concentration camp
• Natural or manmade disasters
• Severe automobile accidents
• Being diagnosed with a life-threatening illness
• Observing the serious injury or unnatural death of another person due to
violent assault, accident, war, or disaster
• Unexpectedly witnessing a dead body or body parts

10. • It is shorter, is easier to use, and is highly correlated with the CAPS,
which is more time-consuming and less practical for use in clinical
practice
• Scores:
- 5 or less reflects no or minimal PTSD symptoms
- 7 equals mild symptoms
- 15 moderate symptoms
- 21 indicates severe symptoms
• Remission in PTSD should be defined as no longer meeting the
diagnostic criteria for the disorder, full functionality, and no or minimal
anxiety and depression symptoms.
Can J Psychiatry, Vol 51, Suppl 2 July 2006

11. • Sometimes hard because people expect to be able to handle a
traumatic even on their own
• People may blame themselves
• Traumatic experience might be too painful to discuss
• Some people avoid the event all together
• PTSD can make some people feel isolated making it hard for them to
get help
• People don’t always make the connection between the traumatic
event and the symptoms; anxiety, anger, and possible physical
symptoms
• People often have more than one anxiety disorder or may suffer from
depression or substance abuse

12. In the military, soldiers engage in combat, and are involved on missions that expose them to
horrible and life-threatening experiences.

13. Examples can include:
• Getting shot/tortured, or witnessing a comrade getting shot/tortured
• Experiencing or witnessing rape
• Having to kill, torture the enemy
• Sustaining life threatening injuries
• Unable to help a comrade
• Feeling of guilt and helplessness due to not being able to act
Research studies have found that certain factors make it more likely
that service members will develop PTSD. These factors include:
• Longer deployment time
• Deployment to "forward" areas close to the enemy
• Traumatic brain injury
• Lower rank
• Low morale and poor social support within the unit
• Prior trauma exposure
• Female gender

15. Stress in early childhood
• Children are constantly developing, physically and emotionally.
• internal sources of stress consist of shyness in a child, emotions,
gender, age and intellectual capacity.
• External stressors include separation from family, exposure to
family conflict, abuse, divorce, a new home or school, illness and
hospitalization, death of a loved one, poverty, natural disasters,
and adults’ negative discipline techniques.
Child sexual abuse
• Child sexual abuse or child molestation is a form of child abuse in
which an adult or older adolescent uses a child for sexual
stimulation.
• Child sexual abuse can occur in a variety of settings, including
home, school, or work (in places where child labor is common).
• Sexual abuse by a family member is a form of incest and can
result in more serious and long-term psychological trauma,
especially in the case of parental incest.

17. • Depression is a common problem that
can occur following trauma and can
affect your eating and sleeping, how you
think, and how you feel about yourself.
• PTSD and depression are often seen
together. Results from a large national
survey showed that depression is nearly
3 to 5 times more likely in those with
PTSD than those without PTSD.
Connection between the two
• Many symptoms of depression overlap
with the symptoms of PTSD.
• Both PTSD and depression may involve
greater irritability. It is quite possible to
have both depression and PTSD at the
same time.
• The trauma that caused PTSD also
may cause depression.

18. In general terms, the psychological impact of being taken hostage is
similar to that of being exposed to other trauma, including terrorist
incidents and disasters for adults and children.
Typical adult reactions include:
• Cognitive: impaired memory and concentration; confusion and
disorientation; intrusive thoughts (‘flashbacks’) and memories; denial
(i.e. that the event has happened); hypervigilance and hyperarousal
(a state of feeling too aroused, with a profound fear of another
incident);
• Emotional: shock and numbness; fear and anxiety (but panic is not
common);helplessness and hopelessness; dissociation (feeling
numb and ‘switched off’ emotionally); anger (at anybody –
perpetrators, themselves and the authorities); anhedonia (loss of
pleasure in doing that which was previously pleasurable); depression
(a reaction to loss); guilt (e.g. at having survived if others died, and
for being taken hostage)

19. • Social: withdrawal; irritability; avoidance (of reminders of
the event).
• Two extreme reactions have also been noted, namely,
‘frozen fright’ and ‘psychological infantilism’. The former
refers to a paralysis of the normal emotional reactivity of
the individual, and the latter reaction is characterized by
regressed behaviour such as clinging and excessive
dependence on the captors.

20. • Extended periods of captivity may also lead to ‘learned
helplessness’ in which individuals come to believe that no
matter what they do to improve their circumstances,
nothing is effective. This is reminiscent of the automaton-
like state reported by concentration camp victims
(‘walking corpses’).
The severe and sustained impact on children is
demonstrated by several abductions, including that of the
children involved in the Chowchilla incident in San
Francisco. After that incident (in which 26 children and
their driver were abducted and held in a vehicle
underground) all the children displayed signs of PTSD,
and some symptoms worsened over time (e.g. shame,
pessimism and ‘death dreams’).