Post Traumatic Stress Disorder

POST TRAUMATIC
STRESS DISORDER
PTSD
BY:
MS. MONAL PARMAR

DEFINITION
• PTSD is an anxiety disorder that develop in response to a
stressful event or situation of exceptionally threatening.
acute -duration of symptoms is less than 3 months.
• chronic- 3 months or more.
• delayed –at least 6 months after the stressors

INCIDENCE
 8% OF THE GENERAL POPULATION.
 WOMEN AT HIGH RISK COMPARED TO MEN.
 MOST PREVALENT IN YOUNG ADULTS.
 SINGLED, DIVORCED ,WIDOWED ,SOCIALLY WITHDRAWN
OR OF LOW SOCIO ECONOMIC LEVEL.
 FIRST DEGREE BIOLOGICAL RELATIVES.

RISK FACTORS
LIMITED SOCIAL SUPPORT
HIGH ANXIETY LEVEL .
LOW SELF ESTEEM
.
NEUROTIC AND EXTROVERTED CHARACTERISTICS.
FAMILY HISTORY OF PTSD OR DEPRESSION
HISTORY OF SUBSTANCE ABUSE.

Previous diagnosis of an acute stresas disorder that
failed to resolve within one month.
GENETIC FACTORS

ETIOLOGY
 THE STRESSORS
 INDIVIDUAL VULNERABILITY FACTORS.
 BIOLOGICAL AND NEUROPHYSIOLOGICAL FACTORS.
 PSYCHODYNAMIC FACTOR .
 BEHAVIOURAL MODEL.
 COGNITIVE MODEL
 GENETIC FACTOR.

STRESSORS
• THE NECESSARY
CAUSE OF PTSD IS AN
EXCEPTIONALLY
STRESSFUL EVENT.
•

INDIVIDUAL VULNERABILITY
FACTORS
 CHILDHOOD TRAUMA
 PERSONALITY TRAITS
 INADEQUATE SUPPORT SYSTEM.
 GENETIC VULNERABILITY.
 RECENT EXCESSIVE ALCOHOL INTAKE
 HIGH ANXIETY LEVEL.
 LOW SELF ESTEEM.

BIOLOGICAL
NEUROPHYSIOLOGICAL FACTORS
 NORADRENERGIC AND ENDOGENOUS
OPIATE SYSTEMS ARE HYPERACTIVE.

PSYCHODYNAMIC FACTORS
REVIVAL OF CHILDHOOD TRAUMA CAUSES
MANIFESTATION OF PTSD.

BEHAVIOURAL MODEL
 The trauma is paired through classical conditioned
stimulus.
 Through instrumental learning people develop a pattern
of avoidance of both unconditioned stimulus and
conditioned stimulus.

GENETIC FACTORS
• STUDIES HAVE PROVED THAT
MONOZYGOTIC TWINS ARE MORE PRONE
THAN DIZYGOTIC TWINS.

• Flashbacks
• Nightmares
• Feeling of intense
distress
• Avoid activity
• Avoid place
• Loss of interest in
activity
• Feeling of detached
from other
• Self blame
• Hopelessness
• Suicidal thought
• Alone
• Physical aches &
pain

DIAGNOSTIC
CHARACTERISTICS
• ACCORDING TO DSM IV
 Exposure to traumatic event
 persistent rexperience of trauma
 consistent and persistent avoidance of stimulii associated with
trauma such as avoiding thoughts or places.being unable to
remain aspects of trauma.
 persistent heightened fellings of arousal.
 symptoms more than one month.
 evidence of impairement in functioning.

LABORATORY FINDINGS
STUDIES OF AUTONOMIC FUNCTIONING
eg HEART RATE,
ELECTROMYELOGRAPHY,SWEAT GLAND
ACTIVITY.

DIFFERENTIAL DIAGNOSIS
 ADJUSTMENT DISORDER
 ACUTE STRESS DISORDER.
 OCD
 FLASHBACKS
 ANOTHER MENTAL DISORDER.

MANAGEMENT
 PSYCHO THERAPY
EXPOSURE THERAPY
STRESS MANAGEMENT
EYE MOVEMENT DESCENTIZATION AND
REPROCESSING.
GROUP THERAPY
FAMILY THERAPY

EYE MOVEMENT
DESENSITIZATION &
REPROCESSING

COGNITIVE THERAPY
• IT AIMS AT REDUCING
STRESS.
• ENCOURAGES THE
CLIENT TO TALK
OPENLY.
• ENCOURAGES THE
CLIENT TO FACE
FRIGHTENING
SITUATIONS.
•

BEHAVIOURAL TECHNIQUE
• USEFUL FOR
AVOIDANCE
BEHAVIOUR.
• ENCOURAGES TO
RECALL THEM EITHER
WHILE THEY ARE
RELAXING OR
ANXIOUS.
•

NURSING MANAGEMENT
 establish trust
 encourage the patient to express.
 use crisis intervention.
 deal constructively with patients display of anger.
 help the patient to relieve shame and guilt.
 review the healing process .
 administer medications.

COUNSELLING
avoid lonliness.
communicate
engage in exercises.
avoid stimulus which will increase feelings of
nervousness.
eat nourishing food.
understand that emotiion will be labile.
get back into your normal routine

continue to spend time with others.
you should expect that you may have relapse.or
triggers of extreme sadness.
expect that you may have trouble concenterating.
try to participate in activities.
try to reach out to others it will remove felling of
hopelessness.
trauma reaction will grow less intense and disapear
within few weeks.
seek profesional help.

PROGNOSIS
 30% RECOVER COMPLETELY.
 40% CONTINUE TO HAVE MILD
SYMPTOMS.
 20% EXPERIENCE MODERATE
SYMPTOMS.
 10% REMAIN UNCHANGED OR
WORSE.

NURSING DIAGNOSIS
POST TRAUMA R/T DISTRESSING EVENT
CONSIDERED TO BE OUTSIDE THE USUAL RANGE
OF HUMAN EXPERIENCE.
DYSFUNCTION GRIEVING R/T LOSS OF SELF AS
PERCIEVED PRIOR TO THE TRAUMA.
ANXIETY R/T POST TRAUMA STRESS RESPONSE
AS EVIDENCED BY POOR SLEEP, IRRITABILITY &
COGNITIVE IMPAIREMENT.

COMPROMISED FAMILY COPING R/T
TEMPORARY FAMILY
DISORGANISATION.
POST TRAUMA SYNDROME R/T
PHYSICALAND SEXUALASSAULT.

Post Traumatic Stress Disorder

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Post Traumatic Stress Disorder