Post Traumatic Stress Disorder (PTSD)
1993-4 Full text articles and references
are available by subscription.
Criteria (adapted
from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
[DSM-IV]): The person
has undergone an event which involved a threat to physical integrity
and has responded with horror or helplessness. For more than a month,
the event is persistently re-experienced by recollections, dreams, reliving,
or by intense distress or physiological reaction to reminders of the
trauma (cues). There is persistent avoidance of cues; diminished interest,
intimacy, range of emotions, recall of event details; a sense of a foreshortened
future. Arousal is increased - sleep disturbance, irritability/anger,
lack of concentration, hypervigilance, readily startled. There is significant
distress or impaired functioning, particularly social or occupational.
Psychophysiological testing
Blood-pressure, heart-rate, intensity
of blinking, skin-conductivity and muscle electrical activity could
add some objectivity to what are otherwise subjective criteria[1].
The admissibility of such evidence was untested at the time of writing
(1993).
Client Characteristics
10% of MVA victims with multiple
injuries or whiplash developed post traumatic stress disorder[2].
Sufferers characteristically had horrific memories, did not have a neurotic
predisposition. Mental state at a year could be predicted at three months.
Epilepsy A
minority of patients with PTSD flashbacks appear to be suffering from
a form of temporal lobe epilepsy[3],
as suggested by electroencephalographic (EEG) patterns and dramatic
response to antiepileptic medication.
Treatment The
same authors desensitised the nonepileptics in a novel way - they made
an audiotape of a session in which the patient relived the traumatic
event, then had the patient replay it repeatedly until it became boring.
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