Sareen J. Posttraumatic stress disorder in adults: impact, comorbidity, risk factors, and treatment. Can J Psychiatry. 2014 Sep;59(9):460-7. doi: 10.1177/070674371405900902. PMID: 25565692; PMCID: PMC4168808.

Reference for Comorbidity of PTSD and Other Disorders

It has been found that over 90% of people with PTSD have at least one-lifetime comorbid mental disorder. The most common comorbid disorders include substance abuse disorder, major depressive disorder, and anxiety disorders. There has been increasing evidence that borderline personality disorder and antisocial personality disorder are associated with PTSD.

Boston College

Posttraumatic stress disorder (PTSD) is a psychological disorder that can develop in individuals who have experienced or witnessed extremely stressful or traumatic events. Such events include, but are not limited to, combat, natural disasters, crimes, and sexual traumas, and can affect anyone regardless of background.

Post-Traumatic Stress Disorder (PTSD)

The likelihood of developing PTSD after a traumatic event is influenced by a wide range of factors. These include the nature and severity of the trauma itself, the level of social support available immediately after the event, and subsequent life stressors. Individual characteristics also play a significant role, such as being female, having a lower socioeconomic status, lower intelligence, and a personal or family history of mental disorders. A history of childhood adversity, like abuse or other traumas, is another major predictor.

Risk Factors for PTSD

Comorbidity of PTSD and Other Disorders

•Cognitive Therapy: Used to recognize patterns of thinking that are keeping one stuck

•Exposure Therapy: Helps one to face situations and triggers that set one off so as to learn to better cope with them

•EDMR(eye movement desensitization and reprocessing): combines guided eye movements and exposure therapy to help process traumtic events and better respond to them

•Antidepressants

•Anti-anxiety medications

•Prazosin: Could be used to help with nightmares; should speak with a doctor to see if this medication could be effective for you


PTSD Treatment

In earlier editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), Post-Traumatic Stress Disorder (PTSD) was categorized as an anxiety disorder. However, with the release of DSM-5, its classification was updated, and it is now formally listed within the category of Trauma-and-Stressor-Related Disorders.

Classification of PTSD in the DSM

According to the DSM-5, a formal diagnosis of Post-Traumatic Stress Disorder (PTSD) requires that an individual has been exposed to, witnessed, or experienced the details of a traumatic event. This qualifying event must involve actual or threatened death, serious injury, or sexual violence. Examples of such experiences include combat, physical attacks, sexual assault, natural disasters, terrorist attacks, and automobile accidents.

DSM-5 Diagnostic Criterion for PTSD: Trauma Exposure

Post-Traumatic Stress Disorder (PTSD) is unique among the disorders listed in the DSM because its diagnostic criteria explicitly specify a cause. The required criterion of exposure to an extreme traumatic event makes it the only disorder for which the etiology is a formal part of the diagnosis itself.

Explicit Cause in PTSD Diagnosis

According to the DSM-5, a formal diagnosis of Post-Traumatic Stress Disorder (PTSD) requires that the characteristic symptoms persist for a minimum of one month.

DSM-5 Diagnostic Criterion for PTSD: Symptom Duration

The symptoms of Post-Traumatic Stress Disorder (PTSD) encompass a range of psychological and physiological reactions. These include re-experiencing the trauma through intrusive, distressing memories and flashbacks. Individuals may also actively avoid stimuli associated with the event. Emotionally, they often experience persistent negative states such as fear, anger, guilt, and shame, along with feelings of detachment from others. Behavioral symptoms can include irritability and a tendency toward outbursts. A key physiological symptom is an exaggerated startle response, often described as 'jumpiness'.

Symptoms of Post-Traumatic Stress Disorder (PTSD)

According to the National Comorbidity Survey, approximately 7% of adults in the United States experience Post-Traumatic Stress Disorder (PTSD) during their lifetime.

Prevalence of PTSD in the United States

Learning models for PTSD propose that classical conditioning is a key mechanism in both the development and maintenance of symptoms. In this framework, the traumatic experience itself functions as an unconditioned stimulus that naturally elicits an unconditioned response of intense fear. Cues from the environment, as well as cognitive, emotional, and physiological states associated with the trauma, become conditioned stimuli. When an individual later encounters these cues, which act as traumatic reminders, they trigger a conditioned response of fear and anxiety, similar to the reaction during the original event.

Classical Conditioning as a Learning Model for PTSD

The cognitive model of PTSD, proposed by Ehlers and Clark (2000), posits that cognitive factors are central to how the disorder develops and persists. This theory identifies two critical processes: disturbances in how memories of the traumatic event are processed and stored, and the negative interpretations an individual makes about the trauma and its consequences.

Cognitive Model of PTSD

Analyze the following scenario and identify the psychological disorder that best explains the individual's behavior. Justify your answer by connecting specific behaviors from the scenario to the core symptoms of the disorder.

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