II. Causes: Common Related Traumas leading to Acute Stress Disorder and PTSD
- Natural disaster
- Earthquake
- Flooding
- Hurricane
- Structure Fire or explosion
- Transportation or Motor Vehicle Accident
- Other serious accident (home, work, recreational)
- Toxic substance exposure
- Physical assault or assault with a weapon
- Sexual Assault or other unwanted sexual experience
- War-related Trauma (combat or war zone exposure)
- Captivity
- Life-threatening illness or injury
- Severe suffering
- Sudden violent death of someone else
- Serious injury, or sudden death of someone close
- Spontaneous Abortion
III. Pathophysiology: Spectrum of Trauma Response
-
Trauma is common (affects 50% of U.S. adults)
- However, <10% develop Posttraumatic Stress Disorder (PTSD)
- Acute stress reaction (normal Trauma response)
- Timing
- Onset within minutes of Traumatic event
- Resolves in hour to days
- Symptoms
- Transient symptoms (e.g. anxiety, Fatigue, decreased concentration)
- Intensity of response varies with event severity
- Re-experiencing symptoms
- Thoughts
- Dreams
- Images
- Intense emotional reactions
- Fear
- Bewilderment
- Anger
- Helplessness
- Despair
- Timing
-
Acute Stress Disorder (exaggerated response)
- Timing
- Onset within 4 weeks of the Trauma
- Duration of symptoms 2 days to 4 weeks
- Symptoms
- Similar symptoms as for acute stress reaction, but more severe and persistent
- Marked symptoms causing significant distress or Impairment
- Timing
-
Posttraumatic Stress Disorder (PTSD)
- Timing
- Persists >4 weeks
- Symptoms
- Marked symptoms, distress and Impairment persist
- Abnormal response to environmental triggers
- Classical conditioned response to Trauma
- Timing
IV. Risk Factors: PTSD
- Severity of Trauma
- Genetic vulnerability (30% association in twins)
- History of previous Trauma
- Preexisting psychiatric disorder
- Family History of psychiatric disorder
- Limited support systems
- Exposure to reactivating environmental events
- LGBTQ patients