Summary
Definition
History and exam
Key diagnostic factors
- exposure and response to trauma
- intrusion symptoms
- avoidance symptoms
- negative alterations in cognitions and mood
- alterations in arousal and reactivity
Risk factors
- serious accident
- witness of school violence or domestic violence
- natural disaster
- terrorist attack
- torture
- combat exposure
- traumatic brain injury
- sudden death of loved one
- molestation
- rape
- victimization by attacker
- previous trauma
- multiple major life stressors
- low social support
- history of mental disorder
- history of drug and alcohol abuse
- female sex
- younger age
Diagnostic investigations
1st investigations to order
- PTSD Checklist
- PTSD Checklist for DSM-5 (PCL-5)
- Impact of Event Scale - Revised (IES-R)
- Davidson Trauma Scale (DTS)
- Trauma Screening Questionnaire (TSQ)
- SPAN
Investigations to consider
- Clinician-Administered PTSD Scale (CAPS)
- Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)
- Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID PTSD Module)
- PTSD Symptom Scale-Interview Version (PSS-I)
Treatment algorithm
Contributors
Authors
Professor of Psychiatric Epidemiology
Centre for Academic Mental Health
School of Social and Community Medicine
University of Bristol
Bristol
Clinical Senior Lecturer & Honorary Consultant Psychiatrist
Institute of Psychological Medicine and Clinical Neurosciences
Cardiff University
Cardiff
UK
Disclosures
SZ declares that he has no competing interests.
Consultant Psychiatrist and Clinical Teaching Fellow
Institute of Psychological Medicine and Clinical Neurosciences
School of Medicine
Cardiff University
Cardiff
Wales
Disclosures
MH is an author of references cited in this topic.
Research Associate
National Centre for Mental Health
Institute of Psychological Medicine and Clinical Neurosciences
School of Medicine
Cardiff University
Cardiff
Wales
Disclosures
CL declares that she has no competing interests.
Dr Stanley Zammit, Dr Mathew Hoskins, and Dr Catrin Lewis would like to gratefully acknowledge Dr Neil P. Roberts, Dr Jonathan I. Bisson, and Dr Steve Wood, previous contributors to this topic.
Disclosures
NPR is a member of the research team that developed a web-based guided self-help program to treat PTSD. NPR has also received grant funding for research related to PTSD and undertaken systematic reviews, meta-analyses, randomized controlled trials, and other research in the traumatic stress field that may be referred to in this work. JIB and SW declare that they have no competing interests.
Peer reviewers
Deputy Associate Chief of Staff
Mental Health
VA New York Harbor Healthcare System
Clinical Associate Professor
New York University School of Medicine
New York
NY
Disclosures
MR declares that he has no competing interests.
Surgeon Commander
Royal Navy
Defence Professor of Mental Health, Visiting Professor of Psychiatry, and Co-Director
Academic Centre for Defence Mental Health
King's College London
London
UK
Disclosures
NG has been principal investigator on studies with research funding greater than 6 figures USD. NG is a director of a company providing early intervention training for traumatic stress (the company does not provide PTSD treatment services).
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