Post-traumatic Stress Disorder (PTSD) is a psychiatric disorder that can occur following a traumatic experience. Many people think aboutPTSD在军事战斗和战争退伍军人的背景下。然而,PTSD症状可以从涉及自然灾害,严重事故,危及生命疾病,身体虐待和童年或成年期的性侵犯的经验中发展。一种创伤tic event前面的PTSD发作可以由个人直接或间接地遇到。学习一个被爱的人如何死亡,或者观看有人受到侵犯,是间接创伤暴露的例子。一种创伤,无论是直接还是间接经历,往往会威胁一个人的自我,世界和未来感,导致创伤暴露的个人体验大量情绪困扰。创伤暴露的患病率超过美国男女的50%。事实上,61%的男性和51%的女性在终身期间至少有一个创伤(Perkonigg,等,2000)。幸运的是,只有8.1%的男性和20.4%的体验创伤的女性继续开发PTSD(Kessler,等,1995)。

由一辆由蓝色汽车击中的车祸中的一个人可能会极其焦虑的驾驶思想,可能会特别注意在路上的其他蓝色汽车。他或她可能会避免完全驾驶,特别是在发生事故的街道上。尽管如此,随着时间的推移,大多数人都会收回他们的生命。虽然可能是违反直觉的,但在创伤后的前三个月,自适应应对策略涉及接受任何负面情绪和对症状的任何负面情绪和表达症状正常,并面对创伤记忆,以便处理它们。对自己善良,了解您的症状作为对创伤的正常反应,而不避免创伤提醒将有助于自然恢复过程。

如前所述所提到的统计数据所示,大多数人在几个月内自然从创伤经验和相关症状中恢复过来。对于大多数个人来说,对于创伤后,大多数人来说也是典型的。创伤事件后的常见反应包括激烈的恐惧和焦虑,通过侵入性记忆和噩梦再次经历创伤,避免创伤提醒,烦躁和愤怒,对令人愉快的活动的损失,睡眠困难,令人内疚感,羞辱,扰乱的关系,对性别,受损的浓度兴趣降低,并激活其他创伤或负面记忆。

Different Traumatic Experiences Yield Different Results

The nature of the trauma and an individual's biology, environment, and life history combine to predispose an individual to PTSD. For example, individuals who are sexually assaulted develop PTSD at much higher rates than individuals who experience other types of noncombat traumas (Kessler, et al., 1995). Moreover, PTSD symptoms are more severe in individuals who experience a particularly jarring or unexpected event, as shown in a study that collected information on the types of stressors identified by ambulance workers (Clohessy & Ehlers, 1999). One ambulance worker in this study reported witnessing dozens of distressing incidents on the job. Yet, his most severe PTSD symptoms and most frequent intrusive memories occurred after he found a dead baby in a bag. As part of his job, he reported mentally preparing for "routine" distressing events, but he never anticipated witnessing something this alarming without warning. He was completely taken off guard, and began questioning his sense of safety, trust, and fairness in the world. For reasons such as these, a traumatic event can be a watershed moment that creates a discontinuity between someone's pre- and post-traumatic life. At its worst, the trauma will cause prolonged symptoms of PTSD that affect an individual's day-to-day well-being.

四种症状症状

Therapists and researchers organize PTSD symptoms into four distinct subgroups: intrusive symptoms, avoidance symptoms, negative alterations in cognition and mood, and alterations in arousal and reactivity. At minimum, an individual with PTSD expresses one intrusion symptom, one avoidance symptom, two cognition and mood symptoms, and two arousal and reactivity symptoms. PTSD symptoms last longer than one month for affected individuals. Examples of symptoms in the four subgroups are listed below:

入侵症状:

  • 不必要的,令人痛苦的创伤事件记忆
  • Recurring trauma-related nightmares
  • 闪回 - 非自愿和生动的重新验收创伤体验
  • 对创伤提醒的强烈情绪痛苦和/或明显的生理反应

避免症状:

  • 持续避免与创伤有关的思想和记忆
  • 持续避免对创伤的外部提醒(例如,创伤发生的位置或让您提醒您创伤的人)

认知和情绪的负面改变:

  • 在创伤的部分内存或释放出来的完全失效或冻结的感觉。
  • Perpetual negative expectations of the world
  • Continuous, misattributed blame of self or others about the traumatic event
  • 持续的负面情绪状态和/或无法体验积极的情绪
  • 损失感兴趣或参与一项感兴趣的重要活动或活动
  • Feelings of detachment from others, as well as feeling like others cannot relate or understand the trauma and emotional burden

一种lterations in Arousal and Reactivity:

  • Easily irritable or angry
  • Reckless or self-destructive behavior (e.g. unprotected sex, reckless driving)
  • 更多警报
  • Easily startled
  • Problems with concentration
  • 睡觉困难,包括睡着和/或睡着了

It is also common for individuals with PTSD to express symptoms of depression. Several overlapping symptoms include impaired睡眠,difficulty concentrating, low energy, agitation, and a loss of interest in things previously found interesting. Moreover, some traumatized individuals turn to alcohol, drugs, or medication to cope with the distress. While taking substances to cope might seem effective in relieving some PTSD symptoms, substance abuse actually interferes with an individual's drive to seek help, cope, and process the trauma in a productive, permanent way.

Treating and Coping With Trauma

面对和谈论一个最令人震惊,令人不安的个人生活经历是无可争议的。寻求帮助采取勇气和愿意脆弱。然而,有几种可用的治疗方法,喜欢长期暴露治疗和认知加工治疗,已在研究研究中显示出改善应激障碍症状,使治疗成为一个有价值的投资。

长期暴露治疗(PE)是PTSD治疗的金标准。通常PE由10-15个治疗课程组成。PE的两种核心组分是可想象的暴露(与创伤记忆重复对抗)和体内曝光(系统对抗与避免创伤相关情况)。PE的其他组分包括处理Imaginal暴露经验,对创伤的常见反应以及焦虑管理(受控呼吸)的教育。

认知加工疗法(CPT)是PTSD的另一个经验支持的治疗方法。CPT针对治疗中的非理性思维和认知扭曲,帮助患者处理他们的创伤记忆。CPT的四个主要组成部分正在学习您的投灾症状,了解思想和感受,学习技能来管理思想和感受,并了解由于创伤而发生的信念的变化。在CPT中,患者会写出他们的创伤叙述,并与治疗师一起揭示认知扭曲。对所有危险的自责和感到无能为力是扭曲思维的两个常见例子。

PE and CPT are two of the more frequently used forms of therapy, but there are more treatment options available. Please visit the Department of Veterans Affairs (VA) website to learn more about other treatment options for PTSD. Additional resources include the Center for the Treatment and Study of Anxiety, the VA's National Center for PTSD, the International Society for Traumatic Stress Studies, and any rape crisis center near you.

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Eugene G. Lipov,M.D.
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Alissa Jerud,博士

注释

Sources

Clohessy,S.和Ehlers,A.(1999)。应激障碍症状,对救护业工作人员的侵入性记忆和应对。英国临床心理学杂志,38(3), 251-265.

Kessler, R., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. (1995). Posttraumatic Stress Disorder in the National Comorbidity Survey.一种rchives of General Psychiatry,52.(12),1048-1060。

Perkonigg,A.,Kessler,R.,Storz,S.,&Wittchen,H.(2000)。社区创伤事件和创伤后应激障碍:流行,风险因素和合并症。一种cta Psychiatr Scand,101.(1),46-59。

Date of original publication:

Updated: May 25, 2017