User:Paddybw

Considering some editing. Would welcome comment before I try.

Posttraumatic stress disorder[1] (PTSD), currently classified as an anxiety disorder, is a medical disorder that can develop after exposure to an extremely challenging, usually life threatening event.[2] [3] The event (stressor) may involve someone's actual death or a threat to the patient's or someone else's life, serious physical injury, or threat to physical and/or psychological integrity, to a degree that the usual biological and psychological defenses are incapable of coping (trauma). PTSD has been recognized in the past as shell shock, traumatic war neurosis and a variety of conditions specifically related to the situations that caused them – e,g. post- Vietnam syndrome. It has also been referred to as post-traumatic stress syndrome (PTSS). The current Diagnostic and Statistical Manual of Mental Disorders of the Americam Psychiatric Association (DSM IV) recognises acute, chronic and delayed subtypes of the disorder and an acute stress disorder that can occur in the immediate aftermath of such events. Combat stress disorder is a variety of acute stress disorder most frequently reported in relation to Israeli battle casualties. It is not included in the DSM IV. The International Classification of Diseases of the World Health Organisation defines PTSD somewhat differently to the DSM classification. New versions of both classifications are anticipated in the near future. Traumatic stress is not a medical diagnosis and is not mentioned in either classification.

In the present “cause” of PTSD the opening statement is –“PTSD is believed to be caused by psychological trauma.[1]”. The DSM strenuously avoids attributing causation in this way and rather details the sorts of events that can lead to PTSD. It would be more balanced to say that PTSD is caused by experiences that negatively affect the biological and psychological functioning of the individual.

While there is commonly a very personal (psychological) story that links directly the event(s) and the disorder it is not uncommon for the individual to deny any problem resulting from their experiences while close family are all too aware of significant changes. This is particularly true of many servicemen and perhaps even more true of many emergency service personnel. Sometimes there is little or no evidence of psychological disturbance, particularly in soldiers who stress the positive elements in their combat experience, when increased physical ill health and early death have been reported.

Lee KA, Valliant GE, Torrey WC et al (1995). A fifty-year old prospective study of psychological sequelae of World War II combat. American Journal of Psychiatry, 152(4):516-522.

The biological response to stress, particularly extreme life threatening stress, is as readily demonstrated in animals as it is in humans.

Friedman MJ, Charney DS, Deutch AY, Eds. 1995. Neurological and Clinical Consequences of Stress. Lippincott-Raven, Philadelphia.