Post Traumatic stress Disorder, PTSD, trauma
The actual name of the post traumatic stress disorder finds its origin in the military (see also Mental disorder). Soldiers who were unfit for service during the Vietnam War due to various war events because they were exposed to the greatest physical or emotional stress were given this diagnosis. In previous wars, the disorder was given different names. In World War I e.g. one used the very apt name "Shell Shock". This called quasi the shock (shock) of the innermost psychic core (shell).
Nowadays diagnosis is also used in civilian areas. Whenever a person is exposed to an event of exceptional physical or mental threat, there is a risk of developing PTSD.
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Women are usually affected much more often than men. Some studies assume a ratio of 2: 1. Possible reasons for this are e.g. the high probability of developing PTSD (post-traumatic stress disorder) after rape (probability approx. 50%), as well as the probability of approx. 20% in victims of violent acts.
The risk for women of becoming a victim of rape once in their life is around 8% in Germany.
Overall, the probability of developing PTSD (post-traumatic stress disorder) once in a lifetime is between 10-12% for women and between 5-6% for men.
Other traumas with a high PTSD risk are: combat deployment in war, child abuse, torture, imprisonment, but also car accidents or being an eyewitness to an accident.
Diagnostic criteria according to ICD-10 / symptoms / symptoms
$config[ads_text2] not foundSymptoms typically appear within 6 months of the stressful event. A later start may also be possible.
The diagnosis should be carried out by a doctor or psychologist experienced in psychotherapy. 2 instruments typically used in diagnostics are:
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"Impact of Event Scale" - R (IES-R) Horowitz et al. 79, German version: Maercker 98
4 factor structure:
The questionnaire is short and simple.
Questionnaire on thoughts after traumatic experiences (PTCI) Foa, Ehlers 2000
Self-disclosure instrument for identifying problematic interpretations of the trauma and its consequences, seven-point Likert scale, 3 factors.
$config[ads_text2] not foundCauses of the development of post-traumatic stress disorder:
Fault concept according to Ehlers and Clark:
fear is a feeling that usually relates to a current or future situation. In PTSD (post-traumatic stress disorder), however, a massive feeling of fear with the above Symptoms due to a past event. In the disorder model according to Ehlers and Clark, it is now assumed that the affected person processed the trauma incorrectly in such a way that memories of the event are perceived as a current, present threat. In terms of perception, it is generally assumed that two processes can be held responsible for the fact that a person perceives past events as currently threatening.
These stimuli remind the patient of stimuli that they perceived shortly before or during the trauma (sounds, smells, etc.). Stimulus and trauma are thus coupled, so to speak. Whenever the patient then perceives such or similar stimuli later, this coupling can make the trauma present again in one fell swoop without the patient being able to explain it.
In addition, patients with PTSD seem to be more attentive to bad, trauma-specific stimuli (so-called priming). (E.g. a woman who was attacked by a bearded man sees men with her beard often immediately out of a crowd.)
As a result, such disturbances in perception usually result in a change in behavior and thoughts. Patients very often tend to avoid situations which they believe may be disturbing. Also, any thoughts about the event are often suppressed. Unfortunately, this avoidant behavior usually has the opposite (paradoxical) effect, i.e. there is an increased occurrence of thoughts and feelings of threat.
The differential diagnoses (alternative causes of illness) are of particular importance. In recent years there has been a kind of “PTSD sell-out”, especially among “non-therapists”. Post-traumatic stress disorder has become a kind of “fashion diagnosis”. This is problematic in that, if the diagnosis is wrong, wrong therapeutic approaches are followed, which on the one hand usually does not really help the patient and on the other hand causes immense costs that could be saved with more precise knowledge of the differential diagnoses. A distinction must be made between the following in terms of differential diagnosis: