Understanding, Assessing and Treating PTSD

Overview of post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop following exposure to a traumatic event or series of events. It is characterised by symptoms that include intrusive thoughts or memories, avoidance of triggers associated with the trauma, negative changes in mood and cognition, and hyperarousal or an exaggerated startle response.The traumatic event can be a direct personal experience, such as a physical or sexual assault, combat exposure, or a natural disaster. It can also be witnessing or learning about a traumatic event that happened to someone else, such as the sudden death of a loved one, a serious accident, or an act of terrorism.As a mental health clinician, it is important to screen and assess for PTSD in patients who have experienced a traumatic event. A thorough assessment should include a detailed history of the event, a review of current symptoms, and an evaluation of comorbid conditions. Treatment should be tailored to the individual and may involve a combination of different approaches, including therapy, medication, and supportive interventions. It is also important to address any barriers to treatment, such as stigma or logistical challenges that may prevent patients from accessing care.

What is post-traumatic stress disorder (PTSD)?

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR), posttraumatic stress disorder (PTSD) is a trauma- and stressor-related disorder that is characterised by the development of specific symptoms following exposure to a traumatic event. The DSM-5-TR defines PTSD as the presence of the following four symptom clusters: intrusion symptoms, avoidance symptoms, negative alterations in cognition and mood, and arousal and hyperactivity symptoms; see the next section for a fuller explanation of these.To receive a diagnosis of PTSD, symptoms must be present for at least one month, cause significant distress or impairment in social, occupational, or other areas of functioning, and not be better explained by other mental health or medical conditions.

What are the symptoms of post-traumatic stress disorder (PTSD)?

As noted above, the DSM-5-TR groups the symptoms of PTSD into four categories: intrusion symptoms, avoidance symptoms, negative alterations in cognition and mood, and arousal and reactivity symptoms.

The symptoms of PTSD can vary in severity and duration. For some individuals, symptoms may begin immediately after the traumatic event, while for others they may not emerge until weeks, months, or even years later. Symptoms can also fluctuate over time, with some periods of remission and others of exacerbation. Note that the diagnosis of PTSD requires that symptoms last for at least one month and cause significant distress or impairment in social, occupational, or other areas of functioning.

1
Intrusion symptoms:

Recurrent, involuntary, and distressing memories, nightmares, or flashbacks related to the traumatic event. This may also include intense psychological distress or physiological reactivity when exposed to cues that resemble the trauma.
2
Avoidance symptoms:

Avoidance of or efforts to avoid trauma-related stimuli, such as thoughts, feelings, or external reminders. This may involve avoiding people, places, or activities that are associated with the traumatic event.
3
Negative alterations in cognition and mood:

This category includes persistent negative beliefs or expectations about oneself or the world, persistent negative emotional states, feelings of detachment or estrangement from others, and inability to experience positive emotions.
4
Arousal and reactivity symptoms:

In this category are irritability, angry outbursts, reckless or self-destructive behaviour, hypervigilance, exaggerated startle response, and difficulty concentrating or sleeping.

How to diagnose PTSD

The diagnosis of post-traumatic stress disorder (PTSD) involves a comprehensive evaluation by a mental health professional, usually a psychiatrist, psychologist, or licensed therapist. The diagnostic process typically involves the following steps:

In summary, the diagnosis of PTSD requires a thorough clinical interview, psychological testing, and a careful evaluation of the DSM-5-TR diagnostic criteria to determine whether the patient's symptoms meet the criteria for the disorder.

1
Clinical interview:

A clinician will conduct a detailed interview with the patient to gather information about the nature and timing of the traumatic event, as well as the patient's symptoms and functional impairment.
2
Psychological testing:

A clinician may use standardised psychological tests or self-report measures to assess the patient's symptoms and cognitive and emotional functioning.
3
Diagnostic criteria:

The clinician will use the diagnostic criteria for PTSD as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) to determine whether the patient meets the criteria for the disorder. The DSM-5-TR requires the presence of specific symptom clusters (intrusion, avoidance, negative alterations in cognition and mood, and arousal and reactivity, as noted), along with functional impairment or distress.
4
Rule out other conditions:

The clinician will rule out other potential causes of the patient's symptoms, such as medical or neurological conditions, substance use disorders, or other mental health disorders.
5
Duration of symptoms:

The diagnosis of PTSD requires that symptoms have persisted for at least one month.
6
Severity of symptoms:

The clinician will evaluate the severity of the patient's symptoms and the level of functional impairment to determine the appropriate treatment plan.

Common treatment approaches for PTSD

Post-traumatic stress disorder can be treated effectively with various evidence-based treatment approaches. The following are some common ones:<ul><li>Cognitive-behavioural therapy (CBT): CBT is a psychotherapeutic approach that aims to help individuals identify and change negative or distorted patterns of thinking and behaviour that contribute to PTSD symptoms. CBT for PTSD often includes exposure therapy, in which the patient is gradually exposed to trauma-related stimuli to reduce avoidance and decrease fear.</li><li>Eye movement desensitisation and reprocessing (EMDR): EMDR is a therapy that uses eye movements or other forms of bilateral stimulation to help individuals process traumatic memories and reduce associated distress. EMDR involves a structured protocol and is based on a theoretical framework that posits that bilateral stimulation enhances information processing.</li><li>Pharmacotherapy: Certain medications, such as selective serotonin reuptake inhibitors (SSRIs) and other antidepressants, can be effective in reducing specific PTSD symptoms, such as anxiety and depression.</li><li>Mindfulness-based therapies: Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), can help individuals increase awareness and acceptance of present-moment experiences and reduce avoidance of trauma-related stimuli.</li><li>Psychodynamic therapy: Psychodynamic therapy focuses on helping individuals explore and process underlying emotional conflicts and attachment patterns that contribute to PTSD symptoms.</li><li>Group therapy: Group therapy for PTSD involves working with a therapist and a small group of individuals with PTSD. The group can provide social support, validation, and normalisation of PTSD symptoms, and it can help individuals build coping skills and increase their sense of self-efficacy.</li><li>Family therapy: Family therapy can help individuals with PTSD and their family members understand and address the impact of PTSD on family dynamics and relationships. Family therapy can also help family members develop effective communication and problem-solving skills.</li></ul>

In general, the most effective treatment for PTSD is likely to be a combination of different approaches tailored to the individual's specific symptoms and needs. The choice of treatment will depend on the severity of the symptoms, the individual's preferences and goals, and the clinician's expertise and experience.

Best practise treatment guides for PTSD

These guidelines provide a comprehensive and evidence-based approach to the assessment and treatment of PTSD. They offer guidance on the most effective interventions for PTSD, including cognitive-behavioural therapy, eye movement desensitisation and reprocessing, and pharmacotherapy. Clinicians are encouraged to review these guidelines to stay up to date on the latest developments regarding this crippling condition.

There are several best practice treatment guidelines for post-traumatic stress disorder that have been developed by professional organisations and expert panels. Some of the most widely recognised treatment guidelines include:

VA/DoD Clinical Practice Guideline for PTSD

This guideline is developed by the U.S. Department of Veterans Affairs and the Department of Defense and provides evidence-based recommendations for the diagnosis and management of PTSD in adults.

International Society for Traumatic Stress Studies (ISTSS) Treatment Guidelines for PTSD

This guideline was developed by a panel of experts in trauma and PTSD and provides evidence-based recommendations for the assessment, diagnosis, and treatment of PTSD.

American Psychiatric Association (APA) Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder

This guideline provides evidence-based recommendations for the diagnosis and treatment of acute stress disorder and PTSD in adults.

National Institute for Health and Care Excellence (NICE) Guideline for PTSD

This guideline was developed by the National Institute for Health and Care Excellence in the UK and provides evidence-based recommendations for the identification, assessment, and treatment of PTSD.

Australian Centre for Posttraumatic Mental Health Treatment Guidelines for PTSD

This guideline was developed by the Australian Centre for Posttraumatic Mental Health and provides evidence-based recommendations for the assessment, diagnosis, and treatment of PTSD.

Common comorbidities with PTSD

Post-traumatic stress disorder is often associated with other mental health conditions, and the presence of comorbidities can complicate treatment and increase the risk of adverse outcomes. The following are some of the most common comorbidities with PTSD:

The presence of comorbidities can complicate the assessment and treatment of PTSD and may require a multidisciplinary approach to care. It is important for clinicians to be aware of the potential comorbidities of PTSD and to screen for these conditions when evaluating individuals with a history of trauma.

1
Depression

PTSD is associated with an increased risk of major depression. Individuals with PTSD and depression may experience more severe symptoms and functional impairment, and treatment for both conditions may be necessary.
2
Anxiety disorders:

PTSD is often comorbid with other anxiety disorders, such as generalised anxiety disorder, panic disorder, and social anxiety disorder.
3
Substance use disorders:

PTSD is associated with an increased risk of substance use disorders, including alcohol use disorder and drug use disorder. Substance use can be a way of self-medicating symptoms of PTSD, and can worsen PTSD symptoms over time.
4
Traumatic brain injury:

Individuals with PTSD may also have a history of traumatic brain injury (TBI), which can result in a range of cognitive, emotional, and physical symptoms that may exacerbate PTSD symptoms.
5
Personality disorders:

PTSD is associated with an increased risk of personality disorders, such as borderline personality disorder and antisocial personality disorder.
6
Medical conditions:

PTSD is associated with an increased risk of several medical conditions, such as chronic pain, cardiovascular disease, and autoimmune disorders.
7
Sleep disorders:

PTSD is often associated with sleep disorders, such as insomnia and nightmares, which can worsen PTSD symptoms and increase the risk of other mental health conditions.

MHA courses on post-traumatic stress disorder (PTSD)

<ul><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/credential/trauma/members'>Working with Trauma: Interventions That Foster Resilience</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/credential/dmhc/members'>Disaster Mental Health Counselling</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/dialectical-behaviour-therapy-for-ptsd'>Dialectical Behaviour Therapy for PTSD</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/recent-advances-in-the-psychological-treatment-of-ptsd'>Recent Advances in the Psychological Treatment of PTSD</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/the-integration-of-cognitive-behaviour-therapy-and-psychodrama-in-trauma-treatment'>The Integration of Cognitive Behaviour Therapy and Psychodrama in Trauma Treatment</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/non-combat-post-traumatic-stress-disorder-in-veterans'>Non-Combat Post-Traumatic Stress Disorder (PTSD) in Veterans: A Focus on Non-Combat Military-Related Trauma</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/diagnosing-trauma-related-disorders'>Diagnosing Trauma-Related Disorders</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/trauma-informed-care-mindfulness-based-treatment-for-post-traumatic-growth'>Trauma Informed Care: Mindfulness-Based Treatment for Post-Traumatic Growth</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/drawing-upon-the-bodys-intelligence-an-introduction-to-sensorimotor-psychotherapy'>Drawing Upon the Body's Intelligence: An Introduction to Sensorimotor Psychotherapy</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/the-abc-model-of-crisis-intervention-working-with-veterans'>The ABC Model of Crisis Intervention: Working with Veterans</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/suicide-prevention-with-disaster-and-trauma-affected-clients'>Suicide Prevention with Disaster- and Trauma-affected Clients</a></li><li><a target='_blank' href='https://www.mentalhealthacademy.com.au/catalogue/courses/post-traumatic-growth-ptg'>Post Traumatic Growth (PTG)</a></li></ul>

Frequently asked questions about PTSD

What strategies can a patient use to manage their post-traumatic stress disorder in daily life?

Individuals with PTSD can use several strategies to manage their symptoms and improve their quality of life. The following may help:<ul><li>Self-care: Practicing self-care can help individuals manage their symptoms and improve their overall wellbeing. This can include regular exercise, healthy eating, getting enough sleep, and engaging in enjoyable activities.</li><li>Mindfulness: Mindfulness can help individuals become more aware of their thoughts, feelings, and physical sensations, and can reduce the impact of traumatic memories on daily life. Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), can be effective in reducing symptoms of PTSD.</li><li>Avoidance and triggers: Avoiding triggers that remind the individual of the traumatic event can be helpful, but can also reinforce avoidance behaviours. Gradual exposure to triggers, in a safe and supportive environment, can be an effective way to reduce the fear and distress associated with the triggers.</li><li>Social support: Having social support from family, friends, or a support group can be helpful in managing PTSD. Support from others can provide validation and understanding and can help reduce feelings of isolation.</li><li>Relaxation techniques: Relaxation techniques, such as deep breathing, progressive muscle relaxation, and guided imagery, can help individuals manage anxiety and stress.</li><li>Structured routine: Establishing a daily routine can provide structure and a sense of control over one's life, which can help manage feelings of anxiety and uncertainty.</li><li>Cognitive-behavioural strategies: Learning cognitive-behavioural strategies, such as cognitive restructuring, can help individuals identify and change negative thought patterns that contribute to PTSD symptoms.</li></ul>Individuals with PTSD should work with a mental health professional to develop a comprehensive treatment plan that includes strategies for managing symptoms in daily life. By using a combination of these strategies, such individuals can learn to manage their symptoms, reduce the impact of the traumatic event on their daily life, and improve their overall well-being.

What therapeutic approaches are most effective in treating patients with post-traumatic stress disorder?

Several evidence-based therapeutic approaches have been shown to be effective in treating PTSD. The following are some of the most commonly used:<ul><li>Cognitive-behavioural therapy (CBT): CBT is a structured psychotherapy that focuses on identifying and changing negative or distorted patterns of thinking and behaviour that contribute to PTSD symptoms. CBT for PTSD typically includes exposure therapy, where patients are gradually exposed to trauma-related stimuli to reduce avoidance and decrease fear.</li><li>Eye movement desensitisation and reprocessing (EMDR): EMDR is a therapy that uses eye movements or other forms of bilateral stimulation to help individuals process traumatic memories and reduce associated distress. EMDR involves a structured protocol and is based on a theoretical framework that posits that bilateral stimulation enhances information processing.</li><li>Prolonged exposure therapy (PE): PE is a form of exposure therapy that involves systematic and repeated exposure to trauma-related memories and stimuli to help reduce the emotional distress associated with the trauma.</li><li>Brief eclectic psychotherapy (BEP): BEP is an integrative psychotherapy that combines elements of CBT, psychodynamic therapy, and interpersonal therapy to help individuals with PTSD. BEP emphasises the importance of developing a strong therapeutic alliance and addressing trauma-related symptoms in the context of the patient's life and relationships.</li><li>Mindfulness-based therapies: Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), can help individuals increase awareness and acceptance of present-moment experiences and reduce avoidance of trauma-related stimuli.</li><li>Group therapy: Group therapy for PTSD involves working with a therapist and a small group of individuals with PTSD. The group can provide social support, validation, and normalisation of PTSD symptoms, and it can help individuals build coping skills and increase their sense of self-efficacy.</li><li>Pharmacotherapy: Certain medications, such as selective serotonin reuptake inhibitors (SSRIs) and other antidepressants, can be effective in reducing specific PTSD symptoms, such as anxiety and depression.</li></ul>The choice of therapeutic approach will depend on the individual's symptoms, preferences, and treatment goals, as well as the clinician's expertise and experience. In general, the most effective treatment for PTSD is likely to be a combination of different approaches tailored to the individual's specific symptoms and needs.

What are the potential complications of PTSD?

Post-traumatic stress disorder can have a significant impact on an individual's life and can lead to several potential complications. Some of the most common ones include:<ul><li>Depression: PTSD is associated with an increased risk of major depression. The presence of depression can exacerbate PTSD symptoms and lead to increased functional impairment.</li><li>Anxiety disorders: PTSD is often comorbid with other anxiety disorders, such as generalised anxiety disorder, panic disorder, and social anxiety disorder. The presence of these disorders can worsen PTSD symptoms and increase functional impairment.</li><li>Substance use disorders: Individuals with PTSD are at an increased risk of substance use disorders, such as alcohol use disorder and drug use disorder. Substance use can be a way of self-medicating symptoms of PTSD, but can also worsen PTSD symptoms over time.</li><li>Suicidal thoughts and behaviours: PTSD is associated with an increased risk of suicidal thoughts and behaviours, particularly among individuals with comorbid depression and substance use disorders.</li><li>Physical health problems: PTSD is associated with an increased risk of several physical health problems, such as chronic pain, cardiovascular disease, and autoimmune disorders.</li><li>Impaired interpersonal relationships: PTSD can interfere with interpersonal relationships, including family and work relationships. Individuals with PTSD may experience difficulties with trust, intimacy, and emotional expression, which can lead to social isolation.</li><li>Impaired occupational functioning: PTSD can lead to difficulties with occupational functioning, including absenteeism, decreased productivity, and impaired work performance.</li></ul>It is important for individuals with PTSD to seek treatment as early as possible to reduce the risk of complications and improve their overall quality of life. Treatment for PTSD can include various therapeutic approaches and medications, and may be tailored to the individual's specific needs and symptoms.

How does PTSD typically affect an individual's mood, energy levels, and motivation?

Post-traumatic stress disorder can have a significant impact on an individual's mood, energy levels, and motivation. The following are some of the most common effects of PTSD on these areas:<ul><li>Mood: Individuals with PTSD may experience a range of mood symptoms, such as irritability, anger, and sadness. These mood symptoms can be triggered by reminders of the traumatic event and can interfere with interpersonal relationships.</li><li>Energy levels: Individuals with PTSD may experience fatigue and decreased energy levels. This can be due to hypervigilance, sleep disturbances, and avoidance behaviours associated with PTSD.</li><li>Motivation: Individuals with PTSD may experience a loss of interest in activities they used to enjoy, and may struggle to find motivation to engage in new activities or pursue their goals. This can be due to a range of factors, including avoidance behaviours, depression, and feelings of hopelessness.</li></ul>In general, the symptoms of PTSD can lead to a decreased quality of life and increased functional impairment. It is important for individuals with PTSD to seek treatment to help manage their symptoms and improve their mood, energy levels, and motivation. Treatment for PTSD can include various therapeutic approaches and medications, and may be tailored to the individual's specific needs and symptoms.

What are the common physical and cognitive symptoms of post-traumatic stress disorder?

PTSD can cause a range of physical and cognitive symptoms. The following are some of the most common:<ul><li>Physical symptoms: Individuals with PTSD may experience physical symptoms, such as headaches, dizziness, chest pain, and gastrointestinal problems. They may also be more sensitive to pain and experience an increased startle response.</li><li>Sleep disturbances: Sleep disturbances, such as insomnia and nightmares, are common in individuals with PTSD. They may have difficulty falling asleep, staying asleep, or experience vivid and distressing dreams related to the traumatic event.</li><li>Avoidance behaviours: Individuals with PTSD may avoid reminders of the traumatic event, including people, places, and situations associated with the trauma.</li><li>Hyperarousal: Hyperarousal is a state of heightened alertness and readiness for danger. Individuals with PTSD may experience hypervigilance, increased startle response, and difficulty concentrating or sleeping.</li><li>Intrusive memories: Intrusive memories, such as flashbacks, can be distressing and disruptive. Individuals with PTSD may experience intrusive memories of the traumatic event, which can be triggered by reminders of the trauma.</li><li>Negative thinking and mood: Individuals with PTSD may have negative thoughts about themselves, others, and the world. They may also experience negative mood symptoms, such as depression and anxiety.</li><li>Memory and concentration difficulties: Individuals with PTSD may experience difficulties with memory and concentration. They may have difficulty recalling details of the traumatic event or other important events in their lives.</li></ul>These symptoms can vary in severity and can have a significant impact on an individual's quality of life. Seeking treatment to help manage symptoms gives a client the greatest chance to improve their overall wellbeing. Treatment for PTSD can include various therapeutic approaches and medications, and may be tailored to the individual's specific needs and symptoms.

How does PTSD typically impact sleep, appetite, and sexual functioning?

Post-traumatic stress disorder can have a significant impact on an individual's sleep, appetite, and sexual functioning. The following are some of the most common effects of PTSD on these areas:<ul><li>Sleep: Individuals with PTSD may experience a range of sleep disturbances, including insomnia, nightmares, and night sweats. These sleep disturbances can be caused by hypervigilance, intrusive memories, and avoidance behaviours associated with PTSD.</li><li>Appetite: Individuals with PTSD may experience changes in appetite, including decreased appetite or overeating. Changes in appetite may be related to depression, anxiety, and other mood symptoms associated with PTSD.</li><li>Sexual functioning: PTSD can have an impact on sexual functioning, including decreased libido, difficulties with arousal, and difficulties with sexual intimacy. These problems may be due to changes in mood, stress, and anxiety associated with PTSD.</li></ul>In general, the symptoms of PTSD can lead to a decreased quality of life and increased functional impairment. It is important for individuals with PTSD to seek treatment to help manage their symptoms and improve their sleep, appetite, and sexual functioning. Treatment for PTSD can include various therapeutic approaches and medications, and may be tailored to the individual's specific needs and symptoms.

Does post-traumatic stress disorder increase a patient's likelihood of suicide, and if so, how can a clinician assess suicide ideation?

PTSD is associated with an increased risk of suicide. Individuals with PTSD may experience intense emotional distress, depression, and feelings of hopelessness, which can increase the risk of suicidal thoughts and behaviours. The following are some ways a clinician can assess suicidal ideation in individuals with PTSD:<ul><li>Directly asking about suicidal thoughts: Clinicians can ask patients directly about suicidal thoughts or intentions, using a non-judgmental and empathic approach.</li><li>Assessing suicide risk factors: Clinicians can assess for known suicide risk factors, such as a history of suicidal behaviour, comorbid mental health conditions, and recent life stressors.</li><li>Identifying warning signs: Clinicians can identify warning signs of suicide, such as talking about feeling hopeless or trapped, giving away possessions, or withdrawing from social activities.</li><li>Conducting a suicide risk assessment: Clinicians can conduct a more comprehensive suicide risk assessment to determine the level of suicide risk, including the presence of protective factors and availability of social support.</li><li>Monitoring for changes in symptoms: Clinicians can monitor for changes in symptoms over time, as increases in symptoms or worsening of PTSD can increase the risk of suicidal thoughts and behaviours.</li></ul>One of the most important aspects of treating clients with PTSD is for clinicians to be aware of the increased risk of suicide and to take appropriate measures to assess for suicide ideation, intervening when necessary. This may include providing crisis management, safety planning, and referral to appropriate mental health services. Additionally, family members, friends, and others close to individuals with PTSD can be educated on the warning signs of suicide and encouraged to seek help if they have concerns about someone's safety.

Recent research on post-traumatic stress disorder (PTSD)

<ul><li>Science Daily – <a target='_blank' href='https://www.sciencedaily.com/news/mind_brain/ptsd/'>PTSD News</a></li><li>Nature Portfolio – <a target='_blank' href='https://www.nature.com/subjects/post-traumatic-stress-disorder'>Post-traumatic stress disorder: Latest articles and news</a></li><li>Hindawi - <a target='_blank' href='https://doi.org/10.1093/ecam/neh127'>Post-traumatic stress disorder: Evidence-based research for the third millenium</a></li><li>Cambridge Core – <a target='_blank' href='https://doi.org/10.1017/S0033291722000927'>Effect of massed v. standard prolonged exposure therapy on PTSD in military personnel and veterans: A non-inferiority randomised controlled trial</a></li><li>JNeurosci - <a target='_blank' href='https://doi.org/10.1523/JNEUROSCI.0911-21.2022'>Hippocampal Threat Reactivity Interacts with Physiological Arousal to Predict PTSD Symptoms</a></li></ul>

References

<ul><li>American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: Fifth edition, text revision. Washington, D.C.: American Psychiatric Association Publishing.</li><li>Health Direct. (n.d.). What is posttraumatic stress disorder? Health Direct. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.healthdirect.gov.au/post-traumatic-stress-disorder-ptsd'>Post-traumatic stress disorder (PTSD) | healthdirect</a></li><li>Mayo Clinic staff. (2023). Posttraumatic stress disorder. Mayo Clinic. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967'>Post-traumatic stress disorder (PTSD) - Symptoms and causes - Mayo Clinic</a></li><li>NHS. (2022). Symptoms: Post-traumatic stress disorder. National Health Service. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/symptoms/'>Symptoms - Post-traumatic stress disorder - NHS (www.nhs.uk)</a></li><li>NIH. (n.d.). Post-traumatic stress disorder. National Institute of Mental Health. Retrieved on 5 April, 2023, from: <a target='_blank' href='https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd'>NIMH » Post-Traumatic Stress Disorder (nih.gov)</a></li></ul>

Understanding, Assessing and Treating PTSD

Guidelines, tools and resources for mental health clinicians

Jump to section

Overview of post-traumatic stress disorder (PTSD)

What is post-traumatic stress disorder (PTSD)?

What are the symptoms of post-traumatic stress disorder (PTSD)?

Intrusion symptoms:

Avoidance symptoms:

Negative alterations in cognition and mood:

Arousal and reactivity symptoms:

How to diagnose PTSD

Clinical interview:

Psychological testing:

Diagnostic criteria:

Rule out other conditions:

Duration of symptoms:

Severity of symptoms:

Common treatment approaches for PTSD

Best practise treatment guides for PTSD

Common comorbidities with PTSD

Depression

Anxiety disorders:

Substance use disorders:

Traumatic brain injury:

Personality disorders:

Medical conditions:

Sleep disorders:

MHA courses on post-traumatic stress disorder (PTSD)

Frequently asked questions about PTSD

Popular books on post-traumatic stress disorder (PTSD)

Recent research on post-traumatic stress disorder (PTSD)

References