Post Traumatic Stress Disorder (PTSD) has been the focus of considerable attention, and some controversy, since it was formally recognised in 1980 by the American Psychiatric Association. This essay will discuss the history of this relatively new diagnosis and its place within the DSM-IV-TR, whilst three perspectives of pathological reaction to trauma, namely, socio-cultural, psychological and biological factors will also be compared. In conclusion this essay will discuss how the three perspectives contrast and contribute to our understanding of PTSD.
PTSD is a common anxiety disorder in Australia with a twelve month prevalence of 3.3% (McLennan 1997, p.18), and in its more serious forms, it is a chronic and disabling psychiatric disorder associated with high co-morbidity and impairment of functioning. The essential feature of PSTD is the development of characteristic symptoms following exposure to an extreme traumatic stressor. This can be a direct personal experience which involves actual or threatened death or serious injury, or witnessing such an event. PTSD is defined by Comer (2002, p. 142) as an anxiety disorder in which fear and related symptoms continue to be experienced long after the traumatic event. PTSD is characterised by the persistent re-experiencing of the traumatic event either in intrusive painful recollections and flashbacks or in dreams, avoidance of situations that trigger the recollection of trauma, numbing of general responsiveness and signs of hyper-arousal.
The possible existence of the disorder can be ascertained by several questions which are based around the DSM-IV-TR. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (AMA) and provides diagnostic criteria for disorders such as PTSD, and is used widely in varying degrees around the world by clinicians and researchers. The DSM-IV-TR represents the current conceptualisation of PTSD and needs to be followed closely to maintain a consistent operational definition of the construct through the field of traumatic stress (Foa et.al 2008, p.26).
The criteria for traumatic stress is defined in DSM-IV-TR as an event either witnessed or experienced which then creates intense feelings of fear, helplessness or horror. Examples of traumatic stressors can include, but are not limited to, plane crashes, sexual assault and rape, war, terrorist attacks, natural disasters such as floods and bushfire and motor vehicle accidents. The DSM subdivides PTSD into two different types: acute, in which the symptoms last less than three months, and chronic, in which they last three or more months (Green & Roberts 2008, p.193). Since the introduction of DSM-IV-TR, the number of possible PTSD traumas has increased and one study suggests that the increase is around 50% (APA 2002, p. 4467)
Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria, and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms, and hyper-arousal symptoms. The fifth criterion concerns duration of symptoms and a sixth assesses functioning. PTSD differs from other anxiety disorders in that the source of stress is an external event of an ...