How Posttraumatic Stress Disorder (PTSD) is Diagnosed

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Maybe there are nightmares that just won’t go away. Perhaps hearing loud sounds is very startling. Violent movies might be just be a little more scary than for everyone else. Posttraumatic Stress Disorder (or PTSD) is an anxiety disorder that affects almost eight percent of Americans adults at some point in their lives. Far from being something that is exclusive to veterans returning from war, it can come upon anyone. Witnessing or experiencing abuse, rape, attempted or successful murder, torture, disaster, illness or even a car accident can set in motion the responses that leads to PTSD.

With so many possible causes, it can sometimes be hard to distinguish a normal reaction to something traumatic from full-blown PTSD. It is only after a full month of experiencing symptoms that it can even be diagnosed. A case might be qualified through a clinical interview, which might also be supplemented by an assessment tool. The MMPI, a common psychological test, has a scale that checks for PTSD. There are other tests and scales as well. An official diagnosis can only be made by a qualified professional, but knowing the criteria can help one see potential symptoms that are developing.

The first thing that has to be established in order to diagnose PTSD is to make sure that the person was exposed to a traumatic event. If this criterion is not met, then the person may have another disorder, like depression or another anxiety disorder. The event must be a situation where the person either experienced, witnessed or was confronted with either actual or threatened death/serious injury, or something that threatened the physical integrity of that person or someone else.

The response to the experience must involve intense fear, helplessness, or horror. If it is a child that has been affected, disorganized or agitated behavior might be experienced instead. Next, the traumatic event must be persistently re-experienced. This can happen in a variety of ways. Distressing images, thoughts, or perceptions of the event might intrude in daily life. Recurring and disturbing dreams might plague the person’s sleep. Sometimes there might even be a feeling as if the event is happening all over again. Anything that serves as a reminder of the event, whether it be something internal or external, might cause psychological or physiological distress.

In children, the ways that the trauma is re-experienced can differ. They may repetitively engage in play that expresses themes or aspects of the trauma. Their nightmares might have unrecognizable content, but be full of fear. Children may even act out the actual trauma when they feel like it’s happening again.

In addition, to be diagnosed the person must persistently avoid reminders of the trauma and have a newfound numbing of responsiveness. This can be displayed through efforts to avoid thoughts, feelings, conversations, activities, places or people that are associated with or are reminders of the trauma. The person may also have forgotten some important aspects of the trauma. There might be a feeling of detachment or estrangement from others. Some feelings might be difficult to feel, including love. There may be feelings that the person might not have a career, marriage, children or normal life span.

Increased arousal that did not exist before the trauma is also a criterion. This can manifest through difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hypervigilance and exaggerated startle response. These symptoms must be persistent. Finally, the symptoms need to cause significant distress or impairment in either social, occupational, or other important areas of functioning.

Sometimes the symptoms don’t emerge until a while after the traumatic event. If it has been over six months before the criteria are met, then it will be classified as having delayed onset. If the symptoms are experienced for less than three months, then it is considered acute; if they are present for three months or longer, the case is chronic.


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