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Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event. These events can include a serious accident, natural disaster, terrorism, war, rape or who have been threatened with death, sexual violence or serious injury. It is important to remember that PTSD can occur indirectly as well, for example learning about a terrorist attack from a family member. It can also be in repeated exposure to trauma such as in detectives or crime scene investigators or paramedics.

PTSD effects 3.5% of adults in the U.S. every year. One in eleven people will be diagnosed with PTSD in their lifetime. Woman are effected twice as much as men.


The person was exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way:

  • Direct exposure to trauma
  • Witnessing the trauma
  • Learning that a family member or close friend underwent trauma
  • Indirect exposure to details of trauma, usually in the course of professional duties (detectives, crime scene investigators)

Intrusive thoughts

The traumatic event is persistently re-experienced in the following way:

  • Repeated, unwanted and upsetting memories
  • Nightmares or distressing dreams
  • Flashbacks of the traumatic event
  • Emotional distress after exposure to traumatic reminders
  • Physical reactivity after exposure to traumatic reminders (fast heartbeats, Shortness of breath)


Avoidance of trauma-related stimuli in the following way:

  • Avoiding people, places, activities, objects and situations that may trigger distressing memories
  • Avoid remembering or thinking about the traumatic event
  • Commonly resist talking about what happened

Negative alterations in cognitions and mood

Negative thoughts or feelings that began or worsened after the trauma, in the following way:

  • Inability to remember important aspects of the trauma
  • Overly negative thoughts and feelings leading to distorted views of oneself or the world “I am a bad person”
  • Exaggerated blame of self or others for causing the trauma
  • Ongoing fear, guilt, shame, anger or horror
  • Decreased interest in activities that were once enjoyable (anhedonia)
  • Feeling isolated
  • Difficulty experiencing positive or good emotions

Alterations in arousal and reactivity

Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way:

  • Irritability or having angry outbursts
  • Acting in a self-destructive way or taking on risky behavior
  • Hypervigilance (watching ones surroundings in a suspecting way and being overly watchful)
  • Heightened startle response (someone jumps when the door slams)
  • Difficulty concentrating
  • Difficulty sleeping (waking up frequently, waking up in cold sweats)


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