Post-Traumatic Stress Disorder

Table of Contents

Introduction.....................................................................................................3

Risk Factors....................................................................................................3

Pathophysiology................................................................................................4

Clinical manifestation.........................................................................................5

Diagnostic criteria.............................................................................................5

Laboratory and Diagnostic test..............................................................................6

Evaluation & Treatment.......................................................................................6

Prognosis........................................................................................................6

Summary........................................................................................................7

There are hundreds of different kinds of psychiatric disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV). One of them is called Post-traumatic stress disorder (PTSD). Based on the research, post-traumatic disorder usually occurs following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape (Harvard Women's Health Watch, 2005). The purpose of this paper is to discuss the risk factors, pathophysiology, clinical manifestation, diagnostic criteria and tests, treatment, prognosis and future research and approaches to treat this psychiatric illness of post-traumatic stress disorder.

Risk Factors

As to all other kinds of disorders, determining the risk factors is a major influential aspect of a person's life in exposing herself to such diseases and illnesses. The factors that put people at risk for post-traumatic disorder are having a history of physical, emotional and sexual abuse. In addition to that, people who have been abused as children or who have had other previous traumatic experiences at a time in their lives are more highly to develop the disorder (Harvard Women's Health Watch, 2005). Other risk factors that contribute to PTSD include motor vehicle crashes, disasters, torture, and comorbid substance abuse (Miller, 2000). The most common precipitating events for PTSD in women were rape and physical assault. For men, physical assault and other traumas were the most prevalent. However, both genders are at heightened risk for PTSD when it comes to motor vehicle accidents. These are the major risk factors people may face that predict the likelihood of post-traumatic stress disorder to occur. Furthermore, according to Harvard Women's Health Watch 2005, people do not necessary have to encounter the traumatic events directly in order for PTSD to develop.

Pathophysiology

Until now, there has not been a definite understanding of how post-traumatic stress disorder occurs in the brain. The exploration into its pathophysiology is fairly recent. However, there is research around it discussing about PTSD's pathophysiology and coming to a complete understanding. In a normal person without the disorder, a stress hormone, adrenaline, releases from the body and prepares it to flee or fight from any stressful, traumatic events. "In the brain, adrenaline and the brain chemical norepinephrine stimulate the amygdala, a deep brain structure that spurs the formation of vivid, emotional memories of the threat," (Harvard Women's Health Watch, 2005, p. 5). In contrast, a post-traumatic stress disorder person's system would seem to be oversensitive. Source says the amygdala may look to be over reactive in PTSD, but it posts a question upon if the amygdala is already over reactive in itself or it could naturally be over reactive responding to trauma (Harvard Women's Health Watch, 2005). With the help of imaging techniques and its imaging studies, it shows that the hippocampus and the anterior cingulated cortex found to be smaller in PTSD. The two areas of the brain which help maintain the amygdala in check seem to have trouble functioning properly in people with PSTD (Harvard Women's Health Watch, 2005). Another thought that involves the pathophysiology of PTSD is the role of basal catecholamines. However, the subject is controversial (Miller, 2000). There has been a hypothesis made that cerebrospinal fluid (CSF) corticotrophin-releasing hormone (CRH) concentrations increase in people with PTSD from a study comparing combat veterans and normal volunteers (Miller, 2000). As with any disorder of the brain, the complexities of PTSD are extensive and require a lot of integrating components. Therefore, the pathophysiology of PTSD is unclear.

Clinical Manifestation

Post-traumatic stress disorder falls into three general categories of symptoms: Intrusion, avoidance, and arousal. Intrusion is repeatedly re-living the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma, causing intense emotional and physical distress (Harvard Women's Health Watch, 2005).

Second category of PTSD symptoms, avoidance, involves the numbing of general responsiveness and the avoidance of stimuli associated with the trauma. Those include places, thoughts, activities, and many more (Harvard Women's Health Watch, 2005).

Finally, symptoms of arousal include difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hypervigilance, and an easy startle response (Harvard Women's Health Watch, 2005). These symptoms are usually experienced after a trauma and are considered chronic PTSD if lasting more than three months.

Having