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1. 8 categories of criterion and at least one symptom from each category are required to diagnose

2. Criterion A (one required): The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

Direct exposure

Witnessing the trauma

Learning that a relative or close friend was exposed to a trauma

Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)

3. Criterion B (one required): The traumatic event is persistently re-experienced, in the following way(s):

Unwanted upsetting memories

Nightmares

Flashbacks

Emotional distress after exposure to traumatic reminders

Physical reactivity after exposure to traumatic reminders

4. Criterion C (one required): Avoidance of trauma-related stimuli after the trauma, in the following way(s):

Trauma-related thoughts or feelings

Trauma-related reminders

5. Criterion D (two required): Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

Inability to recall key features of the trauma

Overly negative thoughts and assumptions about oneself or the world

Exaggerated blame of self or others for causing the trauma

Negative affect

Decreased interest in activities

Feeling isolated

Difficulty experiencing positive affect

6. Criterion E (two required): Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

Irritability or aggression

Risky or destructive behavior

Hypervigilance

Heightened startle reaction

Difficulty concentrating

Difficulty sleeping

7. Criterion F (required): Symptoms last for more than 1 month.
Criterion G (required): Symptoms create distress or functional impairment (e.g., social, occupational).
Criterion H (required): Symptoms are not due to medication, substance use, or other illness.
B. Some of the symptoms of PTSD are:

Flashbacks

Trauma-related thoughts

Inability to recall key features of the trauma

Irritability

Risky destructive behavior

8. C. The symptoms must last for more than one month in order to be diagnosed

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5a. We diagnosed Iron Man with PTSD because he suffers through what he calls “anxiety attacks,” where he experiences clear symptoms of the disorder. He had gone through a near-death, traumatic experience, where he blocked a nuclear missile that was heading towards Manhattan and this causes his suit to use all of its power possible before the Hulk saves him from his death.

5b. Iron Man exhibits symptoms of PTSD using the criterion in the DSM. He has had exposure to a traumatic experience, and has persistent re experience and avoidance. His symptoms remained persistent for over a month, as he has trouble falling asleep and experiences frequent panic attacks. These symptoms fit within the criterion of the DSM and he can be clinically diagnosed with the disorder.

5c. Video link: https://www.youtube.com/watch?v=8obR6vTaly0

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ai. Article: https://psyche.media/what-it-s-like-to-have-ptsd

aii. This article provides very detailed and intense imagery from a person who has PTSD and metaphorically compares it to a monster that is holding the writer hostage and is demanding them to follow all its orders. The writer then goes on to describe the monster as their friend because it's the only thing that they have anymore and that it completely defines them.

Bi. More information:

https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

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Patients suffering from PTSD who want to move on from the trauma may part take in Brief Eclectic Psychotherapy (BEP). Using Brief Eclectic Psychotherapy will change the thoughts and feelings that are the result of a traumatic event. A patient must take part in a 16 session treatment period, during this period he/she will recall details of the traumatic memory, learn to reframe negative thoughts, write a letter about the traumatic event, and hold a farewell ritual to leave trauma in the past. Eventually by the end the patient will no longer have PTSD from the event and live a PTSD free life. This therapy should be used when a patient wants to let go of the trauma, coming face to face with it, making them able to move on and live a normal life.

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Written Narrative Exposure: Involves writing about the trauma during sessions. Your provider gives instructions on the writing assignment, allows you to complete the writing alone, and then returns at the end of the session to briefly discuss any reactions to the writing assignment.

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Narrative Exposure Therapy (NET): Developed for people who have experienced trauma from ongoing war, conflict, and organized violence. Talk through stressful life events in order (from birth to the present day) and put them together into a story.

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Brief Eclectic Psychotherapy (BEP): Therapy which practices relaxation skills, recall details of the traumatic memory, reframe negative thoughts about the trauma, write a letter about the traumatic event, and hold a farewell ritual to leave trauma in the past.

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Eye-Movement Desensitization and Reprocessing (EMDR): Helps with process and make sense of your trauma. Involves calling the trauma to mind while paying attention to a back-and-forth movement or sound (like a finger waving side to side, a light, or a tone).

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Cognitive Processing Therapy (CPT): Teaches to reframe negative thoughts about the trauma. Involves talking with your provider about your negative thoughts and doing short writing assignments.

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Prolonged Exposure (PE): Teaches how to gain control by facing your negative feelings. Involves talking about your trauma with a provider and doing some of the things you have avoided since the trauma.

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Stathmin: Protein used by the brain to develop memories in response to fear
Gastrin: Chemical released in the brain during emotional events
5-HTTLPR gene: Controls levels of serotonin (mood).

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Are there environmental causes or triggers?

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Are there environmental causes or triggers?

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Environmental factors associated with PTSD can include being of lower socioeconomic status, lower education levels, exposure to prior trauma (in childhood especially), childhood adversity, family dysfunction, parental death or separation, cultural characteristics, such as self-blaming or fatalistic coping mechanisms. Other environmental factors can include lower overall intelligence and a family history of psychiatric disorders. (Sexual abuse, violence, abuse).

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Studies have shown women are more vulnerable to PTSD at an older age than men. Men are most vulnerable at ages 41-45 years, while women are most vulnerable 51-55.

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Sertraline (Zoloft)

Paroxetine (Paxil)

Fluoxetine (Prozac)

Venlafaxine (Effexor)

Nefazodone (Serzone): A serotonin reuptake inhibitor (SRI) that works by changing the levels and activity of naturally occurring chemical signals in the brain.

Imipramine (Tofranil): A tricyclic antidepressant (TCA) which acts by altering naturally occurring chemicals which help brain cells communicate and can lift mood.

Phenelzine (Nardil): A monoamine oxidase inhibitor (MAOI) which inactivates a naturally-occurring enzyme which breaks down the neurotransmitters serotonin, norepinephrine and dopamine.

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Although PTSD can occur at all ages, research has discovered that the most common ages affected are 15-54. However the most vulnerable ages are 40+.

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What are some known causes of your disorder

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What are some known causes of your disorder

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PTSD can develop after a very stressful, frightening or distressing event, or after a prolonged traumatic experience. Including physical/sexual assault, natural disasters, car crashes, military combat, etc…