Symptoms and Diagnoses

Dr. Jerman
The experience of psychological distress following a traumatic event varies from person to person. Dr. Mansfield, can you tell us about some symptoms of trauma-related disorders and how they are diagnosed?

Dr. Mansfield
Well, Dr. Jerman, traumatic events are naturally upsetting, and a wide range of responses, or symptoms, immediately following a traumatic event are normal and natural. These symptoms are generally grouped into five categories, including:

• Intrusion symptoms
• Negative mood
• Dissociative symptoms
• Avoidance symptoms, and
• Arousal symptoms

Intrusion symptoms include:

• Recurrent, involuntary, and intrusive distressing memories of the traumatic event
• Recurrent distressing dreams related to the event
• Flashbacks in which the individual feels or acts as if the event were recurring, and
• Intense or prolonged distress in response to reminders of the event

Negative mood refers to a persistent inability to experience positive emotions, such as happiness, satisfaction, or affection.

Dissociative symptoms include:

• An altered sense of reality, and
• An inability to remember an important aspect of the traumatic event that is not related to other factors, such as head injury, alcohol, or drugs

Avoidance symptoms include:

• Efforts to avoid distressing memories, thoughts, or feelings about the event, and
• Efforts to avoid reminders of the event

Finally, arousal symptoms include:

• Sleep disturbance
• Irritable behavior and angry outbursts
• Hyper-vigilance
• Problems with concentration, and
• Exaggerated startle response

When nine or more of these symptoms are present for more than three days, but less than a month, a person may be diagnosed with acute stress disorder. If symptoms persist for more than a month, they may be diagnosed with post-traumatic stress disorder, or PTSD.