Post Traumatic Stress Disorder Timeline.pdf
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Post Traumatic
Stress Disorder (PTSD)
Post Traumatic Stress Disorder
Trauma-Related Disorders Timeline
Key Terms
•
Acute Stress Disorder (ASD):
Clinically signifi cant
dissociative symptoms (such as a sense of numbing
and detachment, or amnesia), trauma re-experiencing,
situation avoidance, and increased arousal symptoms
for > 2 days, but < 1 month after exposure to a trauma
•
Post Traumatic Stress Disorder (PTSD):
Clinically
signifi cant trauma re-experiencing, situation avoidance,
and increased arousal symptoms for > 1 month after
exposure
-
Acute:
Symptoms > 1 month, < 3 months
-
Chronic:
Symptoms ≥ 3 months
-
Delayed Onset:
Onset ≥ 6 months
•
Trauma:
Extreme traumatic stressor involving direct
personal experience, witnessing, or learning about an
event involving actual or threatened death or injury.
Response must involve intense fear, helplessness, or
horror
•
Clinically Signifi cant:
Causes distress or impairment
in social, occupational, and other important areas of
functioning
•
Acute Stress Reaction (ASR) during Ongoing
Military Operation or Combat and Operational Stress
Reaction (COSR):
Physical, mental, and emotional
signs resulting from heavy mental and emotional
work during diffi cult conditions. Symptoms—including
depression, fatigue, anxiety, decreased concentration/
memory, and hyperarousal—that do not resolve within 4
days of event
Reference:
VA/DoD Clinical Practice Guideline for Management of Post-Traumatic Stress, Version 2.0, 2010
DHCC Clinicians Helpline: 1 (866) 559-1627 DSN: 469-1517 www.PDHealth.mil
PDH-CPG Tool Kit Pocket Cards Version 2.0 November 2011
Post Traumatic Stress Disorder (PTSD)
Risk Factors
Pre-Traumatic Factors
• Ongoing life stress or demographics
• Lack of social support
• Young age at time of trauma
• Pre-existing psychiatric disorder
• Other pre-traumatic factors including: female gender, low socioeconomic status, lower level of education, lower level
of intelligence, race (African-American, American Indian, Pacific Islander), prior trauma exposure (reported abuse in
childhood, report of other previous traumatization, report of other adverse childhood factors), family history of psychiatric
disorders (genetics)
• Severe trauma
• Type of trauma (interpersonal traumas such as torture,
rape or assault increase the risk of PTSD)
• High perceived threat to life
• Age at trauma (school age youth, 40-60 years old)
• Community (mass) trauma
• Other peri-traumatic factors including: history of peri-
traumatic dissociation and interpersonal trauma
Post-Traumatic
• Ongoing life stress
• Lack of social support
• Bereavement
• Major loss of resources
• Other post-traumatic factors including: children at home and female with distressed spouse
DHCC Clinicians Helpline: 1 (866) 559-1627 DSN: 469-1517 www.PDHealth.mil
PDH-CPG Tool Kit Pocket Cards Version 2.0 November 2011
Post Traumatic Stress Disorder (PTSD)
DSM-IV-TR Criteria for PTSD
A.
Thepersonhasbeenexposedtoatraumaticeventin
whichbothofthefollowingwerepresent:
1.
Experienced,witnessed,orwasconfrontedwithan
eventoreventsthatinvolvedactualorthreateneddeath
orseriousinjury,orathreattothephysicalintegrityof
selforothers
2.
Theperson’sresponseinvolvedintensefear,
helplessness,orhorror
1.
Effortstoavoidthoughts,feelings,orconversations
associatedwiththetrauma
2.
Effortstoavoidactivities,places,orpeoplethatarouse
recollectionsofthetrauma
3.
Inabilitytorecallanimportantaspectofthetrauma
4.
Markedlydiminishedinterestorparticipationin
signiicantactivities
5.
Feelingofdetachmentorestrangementfromothers
6.
Restrictedrangeofaffect(e.g.,unabletohaveloving
feelings)
7.
Senseofforeshortenedfuture(e.g.,doesnotexpect
tohaveanormallife)
B.
Thetraumaticeventispersistently
RE-EXPERIENCED
in
one (or more)
ofthefollowingways:
1.
Recurrentandintrusivedistressingrecollectionsofthe
event,includingimages,thoughts,orperceptions
2.
Recurrentdistressingdreamsoftheevent
3.
Actingorfeelingasifthetraumaticeventwererecurring
(includesasenseofrelivingtheexperience,illusions,
hallucinations,anddissociativelashbackepisodes,
includingthosethatoccuronawakeningorwhen
intoxicated)
4.
Intensepsychologicaldistressatexposuretointernalor
externalcuesthatsymbolizeorresembleanaspectof
thetraumaticevent
5.
Physiologicreactivityonexposuretointernalorexternal
cuesthatsymbolizeorresembleanaspectofthe
traumaticevent
D.
Persistentsymptomsofincreased
AROUSAL
(not present
beforethetrauma),indicatedby
at least two
ofthe
following:
1.
Dificultyfallingorstayingasleep
2.
Irritabilityoroutburstsofanger
3.
Dificultyconcentrating
4.
Hyper-vigilance
5.
Exaggeratedstartleresponse
E.
Durationofthedisturbance(symptomsinB,C,andD)is
> 1 month
C.
Persistent
AVOIDANCE
ofstimuliassociatedwiththe
traumaand
NUMBING
ofgeneralresponsiveness(not
presentbeforethetrauma),asindicatedby
three (or more)
ofthefollowing:
F.
Thedisturbancecausesclinicallysigniicantdistress
orimpairmentinfunctioning
DHCC Clinicians Helpline: 1 (866) 559-1627 DSN: 469-1517 www.PDHealth.mil
PDH-CPG Tool Kit Pocket Cards Version 2.0 November 2011
Post Traumatic Stress Disorder (PTSD)
Diagnosis
Primary Care PTSD Screen
(Yes to any two or more questions suggests PTSD)
Askpatient,“Inyourlife,haveyouhadanexperiencethatwassofrighteningorupsettingthatinthe
past month
you…”
•“Havehadnightmaresaboutit,orthoughtaboutitwhenyoudidnotwantto?”
•“Triedhardnottothinkaboutitorwentoutofyourwaytoavoidsituationsthat
remindedyouofit?”
•“Wereconstantlyonguard,watchful,oreasilystartled?”
•“Feltnumbordetachedfromothers,activities,oryoursurroundings?”
DSM-IV Code
DIAGNOSIS
308.3
Acute Stress Disorder (ASD)
309.81
Posttraumatic Stress Disorder (PTSD)
Acute:
Ifdurationofsymptomsislessthan3months
Chronic:
Ifdurationofsymptomsis3monthsormore
With Delayed Onset:
Ifonsetofsymptomsisatleast6months
afterthestressor
DHCC Clinicians Helpline: 1 (866) 559-1627 DSN: 469-1517 www.PDHealth.mil
PDH-CPG Tool Kit Pocket Cards Version 2.0 November 2011
Post Traumatic Stress Disorder (PTSD)
Algorithm B-1 Module B: Assessment and Diagnosis of PTSD
DHCC Clinicians Helpline: 1 (866) 559-1627 DSN: 469-1517 www.PDHealth.mil
PDH-CPG Tool Kit Pocket Cards Version 2.0 November 2011
Plik z chomika:
psychika1
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