PYC4802 (2020) STUDY NOTES
,Post-Traumatic Stress Disorder
Everyone Is Always Nagging About DSM.
A) Exposure
B) Intrusion symptoms, 1>, after event
C) Avoidance of stimuli, after event
D) Negative alterations in cognitions and mood, after event
E) Alterations in arousal and reactivity, 2>
F) Duration (B-E), 1 month>
G) Social, Distress, occupational and other areas
H) Medical, not physiological effects of substance or other medical conditions
45276
Adults, adolescents and children older than 6 years:
A) 4 Exposure
Exposure to actual or threatening death, serious injury, or sexual violence in one or more of the following ways:
1. Directly experiencing the traumatic event(s)
2. Witnessing in person the event(s) as it occurs to others
3. Learning that the traumatic event occurred to a close family member or close friend (death violent or
accidental)
4. repeated extreme exposure to details of traumatic event(s) - 1st responders & police officers)
repeated exposure does not apply to exposure through electronic media, television or movies, unless exposure is
work related
B) 5 Intrusion symptoms 1>, onset after event
1. recurrent and distressing Memories of TE
2. distressing Dreams related to TE
3. Flashbacks – individual feels or acts as if TE were recurring
4. Intense Psychological distress to cues resembling TE
5. Physiological reaction to cues resembling TE
,C) 2 Avoidance of stimuli, onset after event
1. Avoidance or efforts to avoid distressing memories, thoughts or feelings associated with traumatic event(s).
2. Avoidance or efforts to avoid external reminders (places, people, activities) that arouse memories, thoughts
or feelings associated with traumatic event(s).
D) 7 Negative alterations in cognitions and mood, onset after event
1. Dissociative amnesia – inability to remember important aspects of traumatic event(s)
2. Negative beliefs or expectations about oneself, others or the world – no one can be trusted, world is a
dangerous place.
3. Distorted cognition about cause of traumatic event – leading to self-blame.
4. Negative emotional state – fear, anger, guilt, shame.
5. Anhedonia – inability to experience positive emotions (happiness, love)
6. No interest in activities.
7. Feelings of detachment.
8.
E) 6 Alterations in arousal and reactivity, 2>
1. Sleep disturbances -difficulty falling or staying asleep
2. Problems with concentration
3. Irritable and angry – expressed verbally or physically
4. Hypervigilance – sensory sensitivity
5. Magnified startle response
6. Self-destructive and reckless behaviour
F) Duration
Duration of disturbances B, C, D, E is more than 1 month
G) Distress
Disturbances causes clinically significant distress in social, occupational or other important factors of functioning.
H) Medical
Disturbances is not attributed to physiological effects of a substance (medication, alcohol), or another medical
condition.
Specify whether:
• PTSD and depersonalisation (outside oneself)
• PTSD and derealisation (dreamlike state)
Specify if:
Delayed expression – if full diagnostic criteria is not met until at least 6 months after the event occurred
DEFINITIONS
PTSD: ASD and PTSD are the two disorders that have special relevance to our country with its high rates of violence
and crime. These disorders are extreme psychological reactions to an intensely traumatic or violent event, such as
assault, sexual assault, natural disasters, accidents and wartime trauma.
, Exam Questions:
Question 1
South Africa is regarded as having a ‘culture of violence’ Critically discuss the diagnosis of
Post-Traumatic Stress Disorder and its characteristics. In addition, discuss factors which
would influence the assessment of PTSD in light of wider contextual factors [25 marks]
Definitions:
PTSD is classified as a trauma and stressor related disorder n the DSM5. Diagnosis requires that a person has been
exposed to a traumatic event that led to a response of intense fear, helplessness and horror. This traumatic event
could be something that the person experienced directly, or could have witnessed. The person could have been
faced with a near death experience, serious injury or sexual violence on his life or that of a close friend or family
member. The person re-experiences the event and avoids any cue associated with the traumatic event. Symptoms
must last more than 1 month to be diagnosed.
In psychology, culture refers to systems of knowledge, concepts, rules and practices that are learned and
transmitted across generations.
Violence and trauma defined:
Violent crime and trauma are currently normative within South African society. Many commentators have come to
refer to South Africa as a "culture of violence" - a society which endorses and accepts violence as an acceptable and
legitimate means to resolve problems and achieve goals (Vogelman & Simpson, 1990)
Walter (1996), defines violence as: Destructive harm, including not only physical assaults that damage the body, but
also the many techniques of inflicting harm by mental or emotional means.
Introduction:
The relationship between illness and stress depends on the interaction between biological, psychological, social and
social-cultural factors. The diagnosis of PTSD requires that a person is exposed to a traumatic event that led to a
response of fear, helplessness or horror, a traumatic event could refer to exposure to actual or threatening death,
serious injury or sexual violence, experienced either directly of by witnessing events as they occur to others.
Within the South African context of violence and trauma, reports indicate that post-apartheid South Africa has
extremely high rates of violent crimes, sexual violence and domestic abuse. Surveys have found that South Africa
has among the highest incidence of murder, armed robbery and intimate partner violence. There is a high risk for
PTSD associated with political, domestic, criminal, sexual and other forms of assault in the South African population.
DSM5 Criteria for PTSD
See beginning of section
Factors which would influence the assessment of PTSD in light of wider contextual
factors:
,Post-Traumatic Stress Disorder
Everyone Is Always Nagging About DSM.
A) Exposure
B) Intrusion symptoms, 1>, after event
C) Avoidance of stimuli, after event
D) Negative alterations in cognitions and mood, after event
E) Alterations in arousal and reactivity, 2>
F) Duration (B-E), 1 month>
G) Social, Distress, occupational and other areas
H) Medical, not physiological effects of substance or other medical conditions
45276
Adults, adolescents and children older than 6 years:
A) 4 Exposure
Exposure to actual or threatening death, serious injury, or sexual violence in one or more of the following ways:
1. Directly experiencing the traumatic event(s)
2. Witnessing in person the event(s) as it occurs to others
3. Learning that the traumatic event occurred to a close family member or close friend (death violent or
accidental)
4. repeated extreme exposure to details of traumatic event(s) - 1st responders & police officers)
repeated exposure does not apply to exposure through electronic media, television or movies, unless exposure is
work related
B) 5 Intrusion symptoms 1>, onset after event
1. recurrent and distressing Memories of TE
2. distressing Dreams related to TE
3. Flashbacks – individual feels or acts as if TE were recurring
4. Intense Psychological distress to cues resembling TE
5. Physiological reaction to cues resembling TE
,C) 2 Avoidance of stimuli, onset after event
1. Avoidance or efforts to avoid distressing memories, thoughts or feelings associated with traumatic event(s).
2. Avoidance or efforts to avoid external reminders (places, people, activities) that arouse memories, thoughts
or feelings associated with traumatic event(s).
D) 7 Negative alterations in cognitions and mood, onset after event
1. Dissociative amnesia – inability to remember important aspects of traumatic event(s)
2. Negative beliefs or expectations about oneself, others or the world – no one can be trusted, world is a
dangerous place.
3. Distorted cognition about cause of traumatic event – leading to self-blame.
4. Negative emotional state – fear, anger, guilt, shame.
5. Anhedonia – inability to experience positive emotions (happiness, love)
6. No interest in activities.
7. Feelings of detachment.
8.
E) 6 Alterations in arousal and reactivity, 2>
1. Sleep disturbances -difficulty falling or staying asleep
2. Problems with concentration
3. Irritable and angry – expressed verbally or physically
4. Hypervigilance – sensory sensitivity
5. Magnified startle response
6. Self-destructive and reckless behaviour
F) Duration
Duration of disturbances B, C, D, E is more than 1 month
G) Distress
Disturbances causes clinically significant distress in social, occupational or other important factors of functioning.
H) Medical
Disturbances is not attributed to physiological effects of a substance (medication, alcohol), or another medical
condition.
Specify whether:
• PTSD and depersonalisation (outside oneself)
• PTSD and derealisation (dreamlike state)
Specify if:
Delayed expression – if full diagnostic criteria is not met until at least 6 months after the event occurred
DEFINITIONS
PTSD: ASD and PTSD are the two disorders that have special relevance to our country with its high rates of violence
and crime. These disorders are extreme psychological reactions to an intensely traumatic or violent event, such as
assault, sexual assault, natural disasters, accidents and wartime trauma.
, Exam Questions:
Question 1
South Africa is regarded as having a ‘culture of violence’ Critically discuss the diagnosis of
Post-Traumatic Stress Disorder and its characteristics. In addition, discuss factors which
would influence the assessment of PTSD in light of wider contextual factors [25 marks]
Definitions:
PTSD is classified as a trauma and stressor related disorder n the DSM5. Diagnosis requires that a person has been
exposed to a traumatic event that led to a response of intense fear, helplessness and horror. This traumatic event
could be something that the person experienced directly, or could have witnessed. The person could have been
faced with a near death experience, serious injury or sexual violence on his life or that of a close friend or family
member. The person re-experiences the event and avoids any cue associated with the traumatic event. Symptoms
must last more than 1 month to be diagnosed.
In psychology, culture refers to systems of knowledge, concepts, rules and practices that are learned and
transmitted across generations.
Violence and trauma defined:
Violent crime and trauma are currently normative within South African society. Many commentators have come to
refer to South Africa as a "culture of violence" - a society which endorses and accepts violence as an acceptable and
legitimate means to resolve problems and achieve goals (Vogelman & Simpson, 1990)
Walter (1996), defines violence as: Destructive harm, including not only physical assaults that damage the body, but
also the many techniques of inflicting harm by mental or emotional means.
Introduction:
The relationship between illness and stress depends on the interaction between biological, psychological, social and
social-cultural factors. The diagnosis of PTSD requires that a person is exposed to a traumatic event that led to a
response of fear, helplessness or horror, a traumatic event could refer to exposure to actual or threatening death,
serious injury or sexual violence, experienced either directly of by witnessing events as they occur to others.
Within the South African context of violence and trauma, reports indicate that post-apartheid South Africa has
extremely high rates of violent crimes, sexual violence and domestic abuse. Surveys have found that South Africa
has among the highest incidence of murder, armed robbery and intimate partner violence. There is a high risk for
PTSD associated with political, domestic, criminal, sexual and other forms of assault in the South African population.
DSM5 Criteria for PTSD
See beginning of section
Factors which would influence the assessment of PTSD in light of wider contextual
factors:
