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trauma-and-stressors:ptsd [on November 7, 2019]
 trauma-and-stressors:ptsd [on May 27, 2020]
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 ====== Posttraumatic Stress Disorder (PTSD) ====== ====== Posttraumatic Stress Disorder (PTSD) ======
 +{{INLINETOC}}
 ===== Primer ===== ===== Primer =====
 **Posttraumatic Stress Disorder (PTSD) ** is a mental disorder diagnosed after an exposure to trauma, including actual or threatened death, serious injury, or sexual violation. It is characterized by intrusive and distressing memories or dreams, dissociative reactions, and substantial psychological or physiological distress related to the event. A diagnosis of PTSD requires evidence of exposure to trauma, and is characterized by intrusive and dissociative symptoms. **Posttraumatic Stress Disorder (PTSD) ** is a mental disorder diagnosed after an exposure to trauma, including actual or threatened death, serious injury, or sexual violation. It is characterized by intrusive and distressing memories or dreams, dissociative reactions, and substantial psychological or physiological distress related to the event. A diagnosis of PTSD requires evidence of exposure to trauma, and is characterized by intrusive and dissociative symptoms.
  
 == Epidemiology == == Epidemiology ==
-The lifetime prevalence of PTSD is around 6-9%, and up to 30% in US Vietnam veterans.[([[https://​www.ncbi.nlm.nih.gov/​pmc/​articles/​PMC5047000/​|Reisman,​ M. (2016). PTSD Treatment for Veterans: What’s Working, What’s New, and What’s Next. Pharmacy and Therapeutics,​ 41(10), 623.]])] It is more frequent in women than in men, with an onset generally in the mid to late 20s. PTSD is associated with high rates of functional impairment, somatic complaints, suicide risk, and comorbid psychiatric disorders. ​+The lifetime prevalence of PTSD is around 6-9%, and up to 30% in US Vietnam ​War veterans.[([[https://​www.ncbi.nlm.nih.gov/​pmc/​articles/​PMC5047000/​|Reisman,​ M. (2016). PTSD Treatment for Veterans: What’s Working, What’s New, and What’s Next. Pharmacy and Therapeutics,​ 41(10), 623.]])] It is more frequent in women than in men, with an onset generally in the mid to late 20s. PTSD is associated with high rates of functional impairment, somatic complaints, suicide risk, and comorbid psychiatric disorders.
  
 +==== Substance Use and PTSD ====
 +Close to half of individuals seeking substance use disorder treatment also meet criteria for current PTSD, and individuals with co-occurring disorders tend to have poorer treatment outcomes compared with those without such comorbidity.
 ===== Diagnostic Criteria ===== ===== Diagnostic Criteria =====
 == Criterion A (Exposure) == == Criterion A (Exposure) ==
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 </​WRAP>​ </​WRAP>​
 </​WRAP>​ </​WRAP>​
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- 
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 == Specifiers == == Specifiers ==
-<​accordion collapsed="​true">​ 
 <panel icon="​fa fa-search-plus"​ size="​xs"​ title="​Specifiers">​ <panel icon="​fa fa-search-plus"​ size="​xs"​ title="​Specifiers">​
 **Specify if:** **Specify if:**
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   * **With delayed expression**:​ If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate).   * **With delayed expression**:​ If the full diagnostic criteria are not met until at least 6 months after the event (although the onset and expression of some symptoms may be immediate).
 </​panel>​ </​panel>​
-</​accordion>​ 
-</​WRAP>​ 
-</​WRAP>​ 
  
 <callout icon="​fa fa-lightbulb-o"​ type="​success"​ title="​Mnemonic">​ <callout icon="​fa fa-lightbulb-o"​ type="​success"​ title="​Mnemonic">​
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   * ''​**R**''​ - **Re-experiencing** (intrusive thoughts, nightmares, flashbacks, or traumatic memories/​images)   * ''​**R**''​ - **Re-experiencing** (intrusive thoughts, nightmares, flashbacks, or traumatic memories/​images)
   * ''​**A**''​ - **Avoidance** (emotional numbing, detachment from others, flattening of affect, loss of interest, lack of motivation, and persistent avoidance of things associated with the traumatic experience)   * ''​**A**''​ - **Avoidance** (emotional numbing, detachment from others, flattening of affect, loss of interest, lack of motivation, and persistent avoidance of things associated with the traumatic experience)
-  * ''​**U**''​ - **Unable to function** (symptoms ​are distressing and cause significant impairment in social, occupational,​ and interpersonal life)+  * ''​**U**''​ - **Unable to function** (symptoms ​cause negative mood, distress, or cause significant impairment in social, occupational,​ and interpersonal life)
   * ''​**M**''​ - **1 month of symptoms** (at least)   * ''​**M**''​ - **1 month of symptoms** (at least)
   * ''​**A**''​ - **Arousal increased** (insomnia, poor concentration,​ irritable, angry, startle reflex, hypervigilance)   * ''​**A**''​ - **Arousal increased** (insomnia, poor concentration,​ irritable, angry, startle reflex, hypervigilance)
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 ==== Psychotherapy ==== ==== Psychotherapy ====
 Trauma-Focused CBT (TF-CBT), Prolonged Exposure (PE) therapy, and Cognitive Processing Therapy (CPT) has significant efficacy. Trauma-Focused CBT (TF-CBT), Prolonged Exposure (PE) therapy, and Cognitive Processing Therapy (CPT) has significant efficacy.
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 ===== Resources ===== ===== Resources =====
 <WRAP group> <WRAP group>
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   * [[https://​www.ptsd.va.gov/​index.asp|Veteran'​s Affairs: National Center for PTSD]]   * [[https://​www.ptsd.va.gov/​index.asp|Veteran'​s Affairs: National Center for PTSD]]
   * [[https://​www.ptsd.va.gov/​public/​materials/​apps/​ptsdcoach.asp|PTSD Coach (Free App)]]   * [[https://​www.ptsd.va.gov/​public/​materials/​apps/​ptsdcoach.asp|PTSD Coach (Free App)]]
 +  * [[https://​www.amazon.com/​Seeking-Safety-Treatment-Substance-Guilford/​dp/​1572306394/​|Seeking Safety: A Treatment Manual for PTSD and Substance Abuse]]
 </​WRAP>​ </​WRAP>​