Posttraumatic stress disorder
Young children are (more/less) likely to exhibit the symptoms of PTSD.
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 45-year-old woman comes to the clinic for a follow-up appointment three weeks after she was raped in a park near their home. She reports that ever since the event, she has stopped walking their dog in the park, will not leave the home after dark, and has vivid nightmares recounting the event. Her husband adds that she pulls away from him anytime he attempts to be intimate with her. Which of the following is the most likely diagnosis?
Posttraumatic stress disorder, also called PTSD, happens when some memory of a past traumatic event—like war or sexual assault—causes recurrent mental and physical distress in the present.
The DSM-5 categorizes PTSD as a “trauma-and-stressor-related-disorder” that happens when the symptoms of an acute stress response persist for over a month.
The main symptoms are psychological.
For example, someone might re-experience their trauma through nightmares, flashbacks, and intrusive thoughts, which can lead to behavioral changes as well.
A person with PTSD might start to avoid environments and situations that remind them of their trauma.
Often, they’ll feel a sense of hypervigilance, where they’re constantly on guard, or hyperarousal, where they have this exaggerated “startle response” to the smallest of triggers.
Not surprisingly, all of these thoughts and behaviours can lead to trouble sleeping and general irritability, which can lead to angry, frustrated outbursts.
Interestingly, this pattern is different for young children, who are less likely to show outward distress; instead, they might use play to express their traumatic memories, acting out scenes that trouble them using toys and games.
Whether or not someone develops PTSD in response to trauma is determined by a number of different factors.
For example, it’s clear that interpersonal trauma like sexual assaults or violent muggings are more likely to result in PTSD than accidents or environmental disasters.
In addition, people who go through extreme trauma as children are more likely to develop PTSD in response to other, further traumas faced in their adult life.
Having said that, if someone manages to develop effective coping strategies for trauma including having a social support network, then that can help with future traumas as well.