Post-Traumatic Stress Disorder

The Spectrum of Post-Traumatic Syndromes

The Basic Stress Responses: Defence and Inhibition

Somatic Stress Syndromes

The Generation of Somatic Symptoms

Diagnostic Integration

Syndromal Diagnosis

Predictors and Risk Factors

Lifetime Development

Comorbidity

Overcoming Anxiety (Home) > Post-Traumatic Stress Disorder > The Spectrum of Post-Traumatic Syndromes

Post Traumatic Stress Syndrome: Symptom and Treatment

What kind of syndromes can be considered as post-traumatic?

When, in 1871, an American army physician, described the syndrome of irritable heart, he described a post-traumatic syndrome within thecultural context of his time relating to the many railway accidents of that time, may have been a varying mixture of neurological damage, psychological arousal and conversion symptoms. The military have offered us other diagnostic entities, which were culturally acceptable presentations of a post-traumatic syndrome, like weakness of the heart, disordered action of the heart, valvular disease of the heart, trench syndrome, shell shock syndrome and combat fatigue.

The observation of the inseparable presence of physical symptoms in psychotraumatic disorders, an American army psychiatrist treating many veterans from World War I, in 1941, to designate posttraumatic neurosis as a physioneurosis . In military life, a notion of psychological distress was not acceptable in general until very recently. In the case of traumatic neurosis, the negative connotation in the sense of secondary gain, in both the Anglo-Saxon and the German ambit, is exemplary in this respect. The Vietnam War has pulled the wall, in a way, leading to the acceptance of post-traumatic stress disorder (PTSD) as a formal diagnosis.

The psychotraumatic syndromes depend in their phenomenology on the developmental stage in which they are induced in any person and by the duration of traumatisation and of the syndrome itself in the individual.

The clinical diagnoses we can arrange within this spectrum are:

1. Borderline personality disorder
2. Behavioural hyperactivity
3. Dissociative disorders
4. Somatoform
5. Post-traumatic stress disorder.
6. Post-traumatic personality change or disorder

The place of attention-deficit/hyperactivity disorder (ADHD) will be discussed below. Variants and combinations can occur, e.g. chronic pain syndromes or self-destructive behaviour in the form of self-cutting or suicide attempts. For borderline personality disorder diagnosed during childhood, it has been argued that it, in fact, constitutes PTSD of early childhood, but more scrutiny reveals that probably several causes or conditions can each contribute to its development. The diagnosis of PTSD in childhood is indeed somewhat different from that of adolescence or adulthood with more emphasis on observable behaviours, such as playing, games and drawings, and developmental progress.

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