Overview
**Characterized by the development of multiple symptoms after exposure to 1+ traumatic events (intrusive sxs, avoidance, negative alterations in thoughts & mood, increased arousal)
TRAUMA OCCURRED AT ANY TIME IN PAST, SXS LAST ≥1MO
Screening-
In past month:
- Had nightmares about the event(s) or thought about the event(s) when you did not want to?
- Tried hard not to think about the event(s) or went out of your way to avoid situations that reminded you of the event(s)?
- Been constantly on guard, watchful, or easily startled?
- Felt numb or detached from people, activities, or your surroundings?
- Felt guilty or unable to stop blaming yourself or others for the event(s) or any problems the event(s) may have caused?
Exposure (1+):
- directly experienced
- witnessed in person
- learning trauma occurred to family/friend
- repeated/extreme exposure to aversive details of trauma
Intrusion (1+):
- memories, dreams, flashbacks, internal/external cues that results in psychological/physiological distress/reactions
Avoidance (1+):
- memories/thoughts/feelings, external reminders (people, places, conversations, situations, etc.)
Negative Alterations in Cognition/Mood (2+):
- memory loss, persistent negative beliefs/expectations of oneself/others/the world
- distorted cognitions about cause/consequence of trauma leadings to blaming of self/others
- persistent negative emotional state (fear, horror, anger, guilt, shame)
- diminished interest/participation in significant activities
- feelings of detachment/estrangement
- inability to experience positive emotions
Alterations in Arousal/Reactivity (2+):
irritable/angry outbursts, reckless/self-destructive, hypervigilance, exaggerated startle response, concentration problems, sleep disturbance
Treatment
Pharmacological:
- SSRIs (sertraline, citalopram) & SNRIs (venlafaxine) first line
- Prazosin (alpha1 Ø) targets nightmares & hypervigilance
- may augment w/ atypical AP in severe cases
Psychotherapy:
- CBT (exposure therapy, cognitive processing therapy)
- EMDR
- supportive & psychodynamic therapy
- couples/family therapy