Abnormal Psychology

Anxiety Disorders 325

Key Concepts and Facts About Posttraumatic Stress Disorder

• Stress disorders are characterized by three types of persistent
  symptoms: reexperiencing the traumatic event avoidance of
  stimuli related to the event, and increased arousal and anxiety.


• DSM-IV-TR includes two types of stress disorder: acute stress
  disorder and posttraumatic stress disorder (PTSD). These
  two disorders are distinguished in part by the timing and du-
  ration of symptoms: Acute stress disorder is diagnosed when
  symptoms arise within 4 weeks of the stressor and have lasted
  for less than 4 weeks; when symptoms last more than 4 weeks
  the diagnosis is PTSD. The diagnostic criteria for acute stress
  disorder also include symptoms of dissociation.
  
  
  • An event is considered traumatic if the individual experi-
    enced or witnessed an actual or threatened death or seri-
    ous injury and responded with intense fear, helplessness, or
    horror. Types of traumatic events are large-scale events with
    multiple victims, unintended acts involving smaller numbers
    of people, and interpersonal violence. Interpersonal violence
    is more likely to lead to a stress disorder, as are other events
    in which the trauma is severe, of long duration, and of close
    proximity.
  
  
  • The DSM-IV-TR diagnosis of PTSD has been criticized because
    the defi nition of traumatic stress is too broad, encompassing
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behavioral interventions to change thinking and behavior) also apparently changed

neurological functioning, as indicated by the reports of decreased hyperarousal.

Successful treatments for PTSD that target one or two factors ultimately affect all

three. Figure 7.18 illustrates these feedback loops in treatment.

Figure 7.18

7.18 • Feedback Loops in Treating Posttraumatic Stress Disorder

Treatments Targeting

Targeting Neurological Factors

Medication: SSRIs,

SNRIs

Changes neural

activity

Decreases isolation

and shame

Social Factors

support

Improves

relationships

Treatments Targeting

Neurological Factors

Cognitive-Behavior Therapy

Couples or family

therapy

IPT

Changes thoughts,

feelings, and

behaviors

Treatments Targeting

Psychological Factors

CBT: Breathing,

relaxation, exposure,

cognitive restructuring,

psychoeducation