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1. Trauma & Posttraumatic Stress Disorder (PTSD) Ichiro Nakagawa, Ph.D.
Mie University
2. What are Trauma & Traumatic Events?
3. DSM-IV Diagnostic and Statistical Manual of Mental Disorders, Forth Edition,
Published by American Psychiatric Association (1994)
DSM-IV TR (Text Revision) 2000
4. Trauma <Definition by DSM-IV>
The person has been exposed to a traumatic event in which both of the following have been present:
the person experienced, witnessed, or was confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
2. the person's response involved intense fear, helplessness, or horror.
5. Traumatic Events and Experiences
From DSM-IV (309.81 Posttraumatic Stress Disorder)
Traumatic events that are experienced directly include, but are not limited to the followings.
6. Traumatic Events and Experiences military combat
violent personal assault
(sexual assaults, physical attack, robbery, mugging)
being kidnapped
being taken hostage
terrorist attack
Torture
7. Traumatic Events and Experiences Continued incarceration as a prisoner of war
or in a concentration camp
natural or manmade disasters
severe automobile accidents
being diagnosed with a life-threatening illness
8. Traumatic Events and ExperiencesWitnessed events observing the serous injury
unnatural death of another person due to violent assaults
accidents
war
disaster
unexpectedly witnessing a dead body or body parts
9. Traumatic Events and ExperiencesEvents experienced by others that are learned violent personal assaults
serious accident
serious injury experienced by a family member or a close friend
leaning about the sudden, unexpected death of a family member or a close friend
or learning that one’s child has a life-threatening disease
10. II. Common Reactions to Traumatic Experiences
11. II. Common Reactions to Traumatic Experiences “Traumatic Stress Reactions”
“Normal reactions to an abnormal situation”
“Resiliency”
Positive outcomes of traumatic experiences
Different Reactions to traumatic events
(Cognitive, emotional, physical, interpersonal)
12. Cognitive Reactions shock
worry
confusion
disbelief
dissociation
intrusive thoughts
memory impairment
impaired concentration
13. Emotional Reactions
fear
anger
guilt
grief
sadness
helplessness
hopelessness
emotional numbing
14. Physical Reactions fatigue
exhaustion
tremor
insomnia
physical pain
hyper-arousal
startle response
gastrointestinal problems
decreased immune function
15. Interpersonal Reactions social withdrawal
poor impulse control
overprotectiveness
increased relational conflicts
sense of alienation and abandonment
altruism (urge to help others)
16. Normal Responses to a traumatic event