7.3. The Symptomatology of Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is characterized by a diverse range of symptoms that can develop in people who have experienced a traumatic event. PTSD symptoms can be physical, emotional, and psychological. It is important to note that not everyone who experiences trauma develops PTSD, and symptoms can appear with varying degrees of intensity. The main symptoms of PTSD are:

1. Recurrent memories (recurrent and intrusive):

   • Distressing memories of the traumatic event.
   • Nightmares and frightening dreams related to the event.
   • Flashbacks, in which the person suddenly relives moments of the trauma in the form of vivid and realistic images.

2. Avoidance and suppression (avoidance of events and places):

   • Avoidance of conversations, places, or events that are reminders of the trauma.
   • Alienation and detachment from others.
   • A feeling that the future is bleak or meaningless.

3. Hyperarousal and increased excitability:

   • Insomnia and restlessness.
   • Irritability and heightened irritability.
   • Increased reactivity to noises or external stimuli.
   • A feeling of heightened readiness to act (hypervigilance).

4. Negative changes in mood and cognitive changes:

   • Negative thoughts about oneself, the world, or the future (feelings of guilt, shame, meaninglessness).
   • Loss of interest in previous hobbies and difficulty experiencing positive emotions.
   • Loss of memory of details of the traumatic event.
   • Difficulty concentrating and making decisions.

5. Physical symptoms:

   • Headaches, abdominal or chest pain.
   • Sleep problems and decreased appetite.
   • Possibly increased blood pressure and stress-hormone levels.

The diagnostic criteria for post-traumatic stress disorder are most fully presented in the DSM-III-R and DSM-IV disease classifications.

A. The event. Post-traumatic stress disorder arises as a
result of psychological trauma. At the basis of psychological trauma lies
a situation that goes beyond the bounds of life experience, and therefore has no
individual precedent for processing. Thus, this situation
becomes a crisis event, from which the individual sees no way out and
falls into a state of severe stress. The crisis situation is associated with
a threat to the life, health, and psychological equilibrium of the subject
themselves, as well as of their relatives and loved ones.
B. The “re-experiencing” group. The psychological trauma
that caused the PTS is re-experienced by the affected person in the following
forms (at least one):
1) recurrent distressing thoughts connected with the “event”;
2) persistent or episodic distressing memories of the psychological trauma; in children this may take the form of repetitive play, in which
the “event” is present;
3) a sudden sense that the “event” and what preceded it is happening again (including sensations, illusions,
hallucinations, and dissociative episodes “flashbacks”);
4) psychological distress in cases when current events resemble or are symbolically connected with the psychological trauma, including
objects, dates (anniversaries), etc.
C. The “avoidance” group. Persistent avoidance of anything that could
be associated with the “event” or serve as a reminder of it.

Along with a general
psychological numbing (at least three items):
1) an effort to avoid thoughts or feelings associated with
the psychological trauma;
2) an effort to avoid situations or actions that might trigger
memories of the psychological trauma;
3) an inability to recall important details connected with
the psychological trauma;
4) a marked loss of interest in previously important aspects
of activity (in children, loss of speech and self-care skills)
5) a feeling of detachment and indifference toward others;
6) a noticeable reduction in the level of positive affective
experiencing (an inability to feel love or joy);
7) a sense of a foreshortened future (an inability to pursue a career, get
married, have children, or live a long life) — the foreshortened-future effect
D. The “general psychological arousal/numbing” group.

Symptoms of increased arousal, absent before the psychological trauma (at least 2 of the following):
1) difficulty falling asleep or staying asleep;
2) irritability or outbursts of anger;
3) decreased concentration, distractibility;
4) heightened caution, exaggerated vigilance;
5) increased startle response (an exaggerated startle reaction to a sudden noise, etc.).

PTSD symptoms may begin immediately after the traumatic event or may appear several months or even years later. They can have a serious impact on a person's quality of life and may require psychotherapeutic and medical care. If you or someone you know has encountered such symptoms, it is important to seek help from mental health professionals in order to receive support and treatment.