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post-traumatic stress disorder

DEFINITION:

The phrase “post-traumatic stress disorder (PTSD)” refers to a mental illness characterized by psychopathological symptoms elicited in a patient by experiencing a violent threat to his or her life or well-being.

ETYMOLOGY:

The phrase PTSD officially entered the medical lexicon with the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), published in 1980.

The concept is much older, arguably being depicted by Homer, by Shakespeare, and by many other literary authors.

The condition began to attract the attention of the psychiatric community around the time of the First World War, when it was known as “shell shock.”

The English term “post-traumatic” is composed of the following two elements:

(1) The prefix “post-,“ which derives, via Middle English, from the Classical Latin adverb and preposition post, meaning “behind” or “after”; and

(2) The adjective “traumatic,” which is allied with the noun “trauma.” The English word “trauma”, which is attested from the late sixteenth century, derives from the ancient Greek noun trauma, traumatos, meaning a “wound.”

The English noun “stress” is attested from the fourteenth century. It derives from the Middle English noun stresse, which is linked to the Middle English noun destresse, meaning “distress.”

The Middle English word destresse, in turn, derives, via Old French, from the Vulgar Latin noun districtia (pl.), meaning “goods that have been distrained” (that is, “detained” or “seized”). The Vulgar Latin word districtia, in turn, derives from the Classical Latin past participle districtus of the verb distringo, distringere, meaning “to draw apart” or “to stretch out.”

For the etymology of the term “disorder,” see the Glossary entry, borderline personality disorder.

DISCUSSION:

Symptoms of PTSDmay include sadness, depression, disturbed thoughts, bad dreams, and nightmares, both related and unrelated to the causative traumatic events.

Both mental and physical distress in PTSD patients may arise in response to trauma-related cues (“triggers”). Attempts by the patient to avoid such cues may themselves be a source of distress.

PTSD may also cause long-term changes in a patient’s cognitive and affective structure, as well as an increase in the fight-or-flight response.

PTSD sufferers are at an increased risk of self-inflicted harm, up to and including suicide.

Among the traumatic events that are known to cause PTSD, one may mention warfare, rape, child abuse, domestic violence, serious illness, severe accidents, loss of significant personal relationships, and other perceived existential threats.

To receive a diagnosis of PTSD, a patient must experience symptoms for a minimum of one month after the causative traumatic event. However, there is no corresponding maximum time limit, as some patients experience symptoms for many years.

In comparison to older patients, children are less likely to develop PTSD in response to trauma.