Disorde and Acute
In every affair, consider what precedes and what follows.
The American Psychiatric Association criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM—IV) (1994) has placed posttraumatic stress disorder and acute stress disorder into two separate categories. Table 5-1 compares these two disorders. A brief review of the major differences is presented in this chapter. The terms applicable to the mental status examination are defined in Appendix B.
Posttraumatic stress disorder (309.81) (PTSD) has been called shell shock, battle fatigue, accident neurosis, and post rape syndrome. It has often been misunderstood or misdiagnosed, even though the disorder has very specific symptoms that form a definite psychological syndrome.
PTSD affects hundreds of thousands of people who have been exposed to violent events such as rape, domestic violence, child abuse, war, accidents, natural disasters, and political torture. Psychiatrists estimate that from 1% to 3% of the population have clinically diagnosable PTSD. More still show some symptoms of the disorder. It was once thought to be a disorder of war veterans who had been involved in heavy combat, although research shows that PTSD can result from many types of trauma, particularly those that include a threat to life. PTSD can affect both females and males (Bile, 1993; Symes, 1995).
Not all individuals who experience PTSD require treatment. Some will recover with the help of strong situational supports such as their family, friends, or a pastor, priest, or rabbi. Many do require professional help to successfully recover from the psychological damage that can result from experiencing, witnessing, or participating in an overwhelming traumatic event.