Posttraumatic Stress Disorder (PTSD) Effectiveness of coping resources.

Presence of pre-existing psychopathology.

Posttraumatic stress disorder can occur in a person who has
witnessed an extraordinarily terrifying and potentially deadly
event. After the traumatic event, the person re-experiences all
or some of it through dreams or waking recollections and
responds defensively to these flashbacks. New behaviors
develop related to the trauma such as sleep difficulties,
hypervigilance, thinking difficulties, severe startle response,
and agitation (APA, 2000).
Posttraumatic stress disorder (PTSD) is described by the DSM-
IV-TR as the development of characteristics symptoms
following exposure to an extreme traumatic stressor involving
a personal threat to physical integrity or to the physical
integrity of others.
The full symptom picture must be present for more than 1
month and cause significant interference with social,
occupational, and other areas of functioning. If the symptoms
have not been present for more than 1 month, the diagnosis
assigned is ACUTE STRESS DISORDERS.
Characteristics symptoms include:
1. Re-experiencing the traumatic event (Flashbacks)
2. A sustained high level of anxiety or arousal.
3. A general numbing of responsiveness.
4. Intrusive recollections or nightmares of the event are
common.
Outcomes of previous experiences with stress/trauma.
Behavioral tendencies (temperament)
Current psychosocial development stage.
Demographic factors (e.g. age, socioeconomic status,
education)
THE RECOVERY ENVIRONMENT. It has been suggested that the
quality of the environment in which the individual attempts to
work through the traumatic experience is correlated with the
outcome. Environmental variable include:
Availability of social supports.
The cohesiveness and protectiveness of family and
friends.
The attitudes of society regarding the experience
Cultural and subcultural influences.
Nursing Interventions:
I. Accept client.
II. Establish trust.
III. Stay with client during flashbacks.
IV. Encourage verbalization of trauma when ready.
V. Discuss coping strategies.
VI. Assist client to try to comprehend the trauma and how it
will be assimilated into his or her persona.

PSCYHOSOCIAL THEORY:

On psychosocial model that has become widely accepted

seeks to explain why certain persons exposed to massive
trauma develop PTSD and others do not. Variables include
characteristics that related to (1) the traumatic experience,
(2) the individual, and (3) the recovery environment.

THE TRAUMATIC EXPERIENCE. Specific characteristics relating

to the trauma have been identified as crucial elements in the
determination of an individual’s long-term response to stress.
They include:

Severity and duration of the stressor.

Degree of anticipatory preparation for the event.
Exposure to death
Numbers affected by the life threat
Amount of control over recurrence
Location where the trauma was experienced (ex: familiar
surroundings, at home, in a foreign country)

THE INDIVIDUAL. Variable that are considered important in

determining an individual’s response to trauma include:

Degree of ego strength