Posttraumatic Stress Disorder (PTSD)

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Posttraumatic stress disorder (PTSD) is a mental health condition that can develop after exposure to one or more traumatic events. The Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5)[1] states that PTSD may also result from direct, indirect or repeated exposure to aversive details of an event, as in the case of first responders or clinicians or other caregivers who work with trauma patients. Many individuals with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares, or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Other characteristic symptoms of PTSD include persistent avoidance of stimuli, negative alterations in cognitions and mood, and marked alterations in arousal and reactivity all associated with the traumatic event[2].

Co-occurrence of PTSD with other mental health conditions is common, such as with substance use disorders, depression, anxiety, chronic health conditions, suicidality, and sleep conditions. While symptoms of PTSD usually develop shortly following a traumatic event, the DSM-5 also includes “delayed expression” PTSD which describes the development of PTSD over a period of time with some symptoms typically appearing immediately, but a full diagnosis is not met until at least six months after the trauma[3].

It is estimated that 8 to 20 percent of the more than 2.6 million service members who deployed in support of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn have or may develop symptoms of PTSD[4]; however, it is important to note that estimates vary widely depending on sampling procedures.

Early detection allows for early intervention. Research indicates that PTSD is treatable and many service members recover with appropriate medication and psychotherapy. In 2004, the Department of Veterans Affairs (VA) and the Department of Defense (DoD) developed the VA/DoD Clinical Practice Guideline for Management of Post-Traumatic Stress to “bring evidence-based practice to clinicians providing care to trauma survivors and patients with stress disorders in the VA and DoD[5].” The clinical practice guideline (CPG) was revised in 2010 and Defense Centers of Excellence supported the development of clinical support tools to help providers comply with the CPG. These tools bring together important resources for providers, patients and family members which support comprehensive, evidence-based treatment of PTSD. For further information about the VA/DoD PTSD CPG and the related clinical support tools, please visit the Treatment Guidance section.

References

[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

[2] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC: Author.

[3] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

[4] Institute of Medicine. (2014). Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment. Washington, DC: The National Academies Press.

[5] Management of Post-Traumatic Stress Working Group. (2010). VA/DoD clinical practice guideline for management of post-traumatic stress (Version 2.0 ed.). Washington, DC: Veterans Health Administration, Department of Defense.