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Introduction to PTSD, Trauma, Abuse and Other Stress-Related Disorders

Post-Traumatic Stress Disorder

PTSD, Trauma, Abuse and Other Stress-Related Disorders: Hope for Healing and Recovery

The media has focused much needed attention on the harmful effects of modern war on returning veterans. As such, nearly everyone has heard of PTSD, which stands for post-traumatic stress disorder. This extra attention has helped many people with PTSD get the help they need. However, PTSD is only one type of unhealed trauma. As the following case illustrates, other lesser-known manifestations of trauma often go unnoticed and/or are misdiagnosed. We hope this article provides hope to anyone who is affected by trauma in all its many forms.

To everyone who knew her, Katrina was the very picture of success. She owned and operated a very successful and profitable business. She drove a nice car, owned a home in a nice neighborhood, and had four children who adored her. She generously volunteered her time to charitable organizations and regularly attended her children's sch...More

Fast Facts: Learn! Fast!

What are Trauma and Stressor-Related Disorders?

  • One of the major changes in the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, 2013) was the inclusion of a new group of disorders called Trauma and Stressor-Related Disorders.
  • This involved the re-classification and modification of several existing disorders that were previously classified elsewhere in the manual.
  • This change in classification reflected a change in our understanding about the impact of unhealed trauma and unmanaged stress on human behavior.
  • Disorders included in this category are

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What are the signs and symptoms of Trauma and Stressor-Related Disorders?

Different configurations of these symptoms form specific diagnoses within the classification of Trauma and Stressor-Related Disorders, but generally include:

  • Intrusive Symptoms - People experiencing these intrusive symptoms describe it as though they are right back there, reliving and re-experiencing the trauma all over again. These are called intrusive symptoms because they are unwanted, unbidden, and therefore, involuntary.
  • Distressing Images, Thoughts, Memories - A distressing memory, image or thought is something that you can't get out of your head related to trauma or stress. These may occur spontaneously, or they may be cued/triggered.
  • Flashbacks, Dissociative Reactions - A flashback, while certainly intrusive, is also dissociative, which means there is a brief or extended period where time and reality are suspended.
  • Distressing Dreams and Nightmares - For some survivors of trauma, nightmares occurred nightly, while for others, the nightmares are less frequent and unpredictable.
  • Intense or Prolonged Psychological Distress - Exposure to reminders or cues associated with a traumatizing experience can trigger symptoms of severe psychological distress such as depression, panic attacks, and even hallucinations.
  • Physiological Distress or Body Memory - The physiological, or body, response to trauma can include gastrointestinal pain, chest pain, light-headedness, tingling sensations, shortness of breath, and unspecified muscle pain.
  • Avoidance Symptoms - Avoidance symptoms represent an effort to withdraw from certain situations that bring about body-level distress of trauma-related symptoms.
  • Negative Thoughts and Feelings - Since unhealed wounds can affect our mood states, it make sense to pay attention to unhelpful thinking patterns, and to explore our feelings about ourselves and the world around us.
  • Arousal and Reactivity Symptoms - This category of symptoms has also been called heightened arousal and includes behaviors like jumpiness, sleep disturbances, irritability and/or aggressive behavior, problems with concentration, and reckless or self-destructive behaviors.

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What causes the symptoms of Trauma-Related Disorders?

In trying to understand the impact of unhealed trauma on the human brain, it\'s helpful to have a basic understanding of the brain.

A simple model of the human brain is to envision it as three separate brains (the triune brain); each with its own separate functions and sense of time. These parts are:

  • R-complex brain or brainstem - The base of the brain contains the cerebellum, and it directly connects to the spinal cord. This part is responsible for functions like reflexive behaviors, muscle control, balance, breathing, heartbeat, feeding/digestion, and reproduction.
  • The limbic brain - This area is the center of emotion and learning. This part also includes the amygdala, which scans for any threat or danger, and sends out a signal to other parts of the brain when a threat is perceived.
  • The cerebral brain or neocortex - this part is responsible for things that make us distinctly human: logic; reasoning skills; analysis and problem-solving; speech and verbal understanding; meaning-making; willpower; and, wisdom.

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How are Trauma and Stressor-Related Disorders treated?

  • The simplest framework for healing trauma dates back to the late 1800s and includes 3 stages - Stabilization, Identification and Relapse prevention.
  • One great misconception about trauma counseling is that once trauma is processed or cleared, then it's gone. A healthier and more accurate approach is to view trauma as something that can be healed, but not cured. A cure implies you either have a disease or disorder, or you do not. Healing implies various degrees of adaptation and adjustment that occur over time.
  • If trauma seems like it might be a factor in your healing journey, finding a trauma-informed therapist is key.
  • Trauma recovery looks different for each survivor. It is largely dependent upon each person's recovery goals.
  • Cognitive therapies focus on modifying those dysfunctional thoughts so that feelings and behaviors improve.
  • Mindfulness teaches people to live in a state of acceptance with a keen awareness of the present moment, and recognizes that thoughts are just that - merely thoughts. They don't represent any truth or reality.
  • Many approaches for healing trauma incorporate an element of exposure therapy.
  • Eye Movement Desensitization and Reprocessing (EMDR) is currently one of the most researched therapies for PTSD, and it now appears on the SAMHSA registry of evidence-based practices.
  • Body, Movement & Expressive Arts Therapies - Because unhealed trauma wreaks havoc on the body, it makes perfect sense to include the body in the healing process.
  • Medications - Before you agree to take a medication, be sure you have specifically mentioned to the provider your trauma background. Many symptoms of trauma and stressor-related disorders look like symptoms of other disorders. Without properly considering your trauma background, your provider may prescribe medications that are not helpful, and may even make things worse.

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News Articles

  • Therapeutic Horseback Riding Can Help Alleviate PTSD in Veterans

    For military veterans, therapeutic horseback riding may be a clinically effective intervention for relieving symptoms of posttraumatic stress disorder, according to a study published online Jan. 19 in Military Medical Research. More...

  • Prazosin Doesn't Alleviate Distressing Dreams in PTSD

    Prazosin does not alleviate distressing dreams among veterans with chronic posttraumatic stress disorder, according to a study published in the Feb. 8 issue of the New England Journal of Medicine. More...

  • Poor Sleep Worsens Link Between PTSD, Chronic Pain in Youth

    Poor sleep worsens the association between posttraumatic stress disorder symptoms and chronic pain in youth, according to a study published in the January issue of the Journal of Pain. More...

  • Can Just 5 Therapy Sessions Work for Those With PTSD?

    A mere five sessions of specialized therapy could help people struggling from post-traumatic stress disorder (PTSD), new research suggests. More...

  • Massed Prolonged Exposure Tx Tied to More PTSD Improvement

    Prolonged exposure therapy administered as mass therapy is associated with a greater reduction in post-traumatic stress disorder symptom severity than a minimal-contact control, according to a study published in the Jan. 23/30 issue of the Journal of the American Medical Association. More...

  • 14 More
    • Written Exposure Therapy Effective PTSD Treatment

      Five sessions of written exposure therapy are efficacious and an efficient treatment for posttraumatic stress disorder, according to a study published online Jan. 17 in JAMA Psychiatry. More...

    • Closed-Loop Neurotechnology Improves PTSD Symptoms

      Service members and veterans show reductions in post-traumatic stress symptomatology, insomnia, depression, and anxiety with use of high-resolution, relational, resonance-based, electroencephalic mirroring, a closed-loop, allostatic, acoustic stimulation neurotechnology, according to a study published online Dec. 22 in Military Medical Research. More...

    • Cancer Survivors Can Develop PTSD, Too

      But new research shows the trauma of a cancer scare often leaves survivors with the condition. More...

    • Stepped Care Intervention Beneficial After Natural Disaster

      A stepped care case-finding intervention is beneficial for individuals with post-traumatic stress disorder after a natural disaster, according to a study published online Oct. 4 in JAMA Psychiatry. More...

    • Transcranial Magnetic Stimulation Aids PTSD in Eating Disorders

      Repetitive transcranial magnetic stimulation of the dorsomedial prefrontal cortex seems to be beneficial for treatment of posttraumatic stress disorder in patients with eating disorders, according to research published online Aug. 16 in the International Journal of Eating Disorders. More...

    • PTSD After Head Injury May Signal Brain Changes

      Study found area linked to emotions was larger in soldiers who had both conditions. More...

    • Risky Behavior Triggers Vicious Cycle for Vets With PTSD

      Report finds reckless acts a symptom of disorder, and they increase the odds of another traumatic experience. More...

    • 'Fight or Flight' Response Greater in Combat Vets With PTSD: Study

      This heightened stress could increase their risk for heart disease, researchers say. More...

    • Genes May Govern Your Risk for PTSD

      Link with the psychiatric disorder is more apparent for women, study contends. More...

    • Non-Invasive Neurotechnology May Help Ease PTSD Symptoms

      Technology using a patient's own brainwaves might offer hope against tough-to-treat posttraumatic stress disorder, according to a study published online April 19 in BMC Psychiatry. More...

    • A 'Brainwave' to Help Fight PTSD

      Study is preliminary, but suggests an acoustic 'feedback' technology might help some patients. More...

    • SGA Prescribing Higher for Veterans With PTSD/Dementia

      Elderly veterans with post-traumatic stress disorder with dementia have increased odds of being prescribed second-generation antipsychotics compared with those with PTSD alone, according to a study published online April 3 in the Journal of the American Geriatrics Society. More...

    • Postcode Stress, PTSD Seen After Unsuccessful Resuscitation

      Critical care nurses who experience unsuccessful cardiopulmonary resuscitation may experience moderate levels of postcode stress and posttraumatic stress disorder symptoms, according to a study published in the March issue of the American Journal of Critical Care. More...

    • Study Probes Causes of Anger in Returning U.S. Soldiers

      PTSD, combat experience and family history can all play roles, study finds. More...

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