As the name of the disorder implies, posttraumatic stress disorder symptoms develop following a traumatic event. The person with post traumatic stress disorder (PTSD) might have “direct personal experience” of a traumatic event entailing serious injury or threatened death or injury of the person; or seeing someone else being threatened, hurt, or killed; or hearing about such an event occurring to a close friend or family member1. As described by the Diagnostic and Statistical Manual of Mental Disorders IV-TR, individuals who have such an experience respond with “intense fear, helplessness, or horror” and they report recurrent re-experiencing of the traumatic event, avoiding things, places, and people related to the event, and feeling more keyed up physiologically1. Diagnostic criteria for PTSD require that these PTSD symptoms be present for at least one month and cause significant distress or impairment1.
Examples of traumatic events experienced directly include military combat, physical or sexual assault, robbery, natural or manmade disaster, car accident, or diagnosis of a life-threatening disease1. Witnessing an event that is traumatic might include seeing someone get seriously hurt or killed1. An event experienced by someone else that could be traumatic to hear might include a severe assault, accident, or injury, or hearing about the sudden death of a close friend or family member1.
It is very common for individuals with PTSD to re-experience the traumatic event in different ways. For example, one might have recurrent images or thoughts of the event that interfere with one’s functioning. Nightmares related to the event can be very upsetting and may lead to sleep disturbance. Illusions or flashbacks might occur where the individual feels or acts as if the traumatic event were happening again1. PTSD symptoms may also include intense physiological or psychological reactions to sensations, things, people, or place that remind them of the traumatic event1.
Since exposure to anything related to the traumatic event produces unpleasant reactions, individuals with PTSD tend to avoid such exposure. That is, they are likely to avoid thoughts, feelings, conversations related to the traumatic event1. They may prefer avoiding people, places, or activities that remind them of the event1; in fact, such efforts to avoid may result in their inability to remember parts of the event. Such individuals might also experience a numbing, such that they do not respond much to what is going on around them1. Similarly, they may report feeling detached from others and difficulty feeling certain emotions involving intimacy, love, and sexuality1. Such individuals may believe that they will have a shorter lifespan1.
The re-experiencing of traumatic event as well as efforts to avoid exposure to things that are related to the event might lead to being keyed up or on edge. For example, an individual with PTSD might have trouble falling asleep or waking up too early1. They might experience irritability or anger outbursts, concentration problems, hypervigilance, or being easily startled1.
PTSD Symptoms in Children: Children endorse similar symptoms as adults, with a few differences. The first distinction has to do with the ways in which individuals respond to traumatic event. Instead of fear and helplessness, children may express disorganized or agitated behavior1. In addition, children may have trouble recounting the event, however they might incorporate themes or aspects of the trauma in their play1. Also, children may experience scary dreams, but they may be unable to recognize the content of the dreams1. Lastly, young children might reenact aspects of the trauma1.
1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.