Posttraumatic stress disorder^[1][2] (PTSD) is an anxiety disorder that can develop after exposure to one or more terrifying events in which grave physical harm occurred or was threatened.^[3] It is a severe and ongoing emotional reaction to an extreme psychological trauma.^[4] This 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 usual psychological defenses are incapable of coping. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // F00-F99 - Mental and behavioural disorders (F00-F09) Organic, including symptomatic, mental disorders (F00) Dementia in Alzheimers disease (F01) Vascular dementia (F011) Multi-infarct dementia (F02) Dementia in other diseases classified elsewhere (F020) Dementia in Picks disease (F021) Dementia in Creutzfeldt-Jakob disease (F022) Dementia in Huntingtons... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Anxiety disorder is a blanket term covering several different forms of abnormal, pathological anxiety, fears, phobias. ... Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event. ... In psychoanalytic theory, a defence mechanism is an unconscious way to protect ones personality from unpleasant thoughts which may otherwise cause anxiety. ... In psychology, coping is the process of managing taxing circumstances, expending effort to solve personal and interpersonal problems, and seeking to master, minimize, reduce or tolerate stress or conflict. ...

PTSD is a condition distinct from Traumatic stress, which is of less intensity and duration, and combat stress reaction, which is transitory. PTSD has also been recognized in the past as shell shock, traumatic war neurosis, or post-traumatic stress syndrome (PTSS). James Brown Is Dead and James Brown Is Still Alive are two of the earliest and best known of a series of electronic dance music references to iconic American entertainer James Brown. ... Image from The Great War taken in an Australian Dressing Station near Ypres in 1917. ...

Causes

Main article: Psychological trauma

PTSD is believed to be caused by psychological trauma.^[1] Possible sources of trauma includes experiencing or witnessing childhood or adult physical, emotional or sexual abuse.^[1] In addition, experiencing or witnessing an event perceived as life-threatening such as physical assault, adult experiences of sexual assault, accidents, illnesses, medical complications, or the experience of, or employment in occupations exposed to war (such as soldiers) or disaster (such as emergency service workers).^[1] In a preliminary study, it has been shown that mutations in a stress-related gene interact with child abuse to increase the risk of PTSD in adults. ^[5][6][7] Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event. ... Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event. ... Physical abuse is abuse involving contact intended to cause pain, injury, or other physical suffering or harm. ... Emotional abuse refers to a long-term situation in which one person uses his or her power or influence to adversely affect the mental well-being of another. ... Bad Touch redirects here. ... Sexual assault is any physical contact of a sexual nature without voluntary consent. ... Illness (sometimes referred to as ill-health) can be defined as a state of poor health. ... Complication, in medicine, is a unfavorable evolution of a disease, a health condition or a medical treatment. ... For other uses, see War (disambiguation). ... This article is about a military rank. ... Emergency services are public services that deal with emergencies and other aspects of Public Safety. ...

Mechanism

Neuroendocrinology

PTSD displays biochemical changes in the brain and body that differ from other psychiatric disorders such as major depression. Individuals diagnosed with PTSD respond more strongly to a dexamethasone suppression test than individuals diagnosed with clinical depression. In addition, most PTSD also show a low secretion of cortisol and high secretion of catecholamine in urine and the norepinephrine/cortisol ratio is consequently higher than comparable non-diagnosed individuals. This is in contrast to the normative fight-or-flight response, in which both catecholamine and cortisol levels are elevated after exposure to a stressor.^{[citation needed]} Brain catecholamine levels are low, and corticotropin-releasing factor (CRF) concentrations are high. Together, these findings suggest abnormality in the hypothalamic-pituitary-adrenal axis (HPA). Given the strong cortisol suppression to dexamethasone in PTSD, HPA axis abnormalities are likely predicated on strong negative feedback inhibition of cortisol, itself likely due to an increased sensitivity of glucocorticoid receptors.^[8] Some researchers have associated the response to stress in PTSD with long-term exposure to high levels of norepinephrine and low levels of cortisol, a pattern associated with improved learning in animals. Translating this reaction to human conditions gives a pathophysiological explanation for PTSD by a maladaptive learning pathway to fear response through a hypersensitive, hyperreactive and hyperresponsive HPA axis.^[9] Biochemistry (from Greek: , bios, life and Egyptian kēme, earth[1]) is the study of the chemical processes in living organisms. ... The dexamethasone supression test is designed to diagnose and differentiate among the various types of Cushings syndrome and other hypercortisol states. ... On the Threshold of Eternity. ... Cortisol is a corticosteroid hormone produced by the Zona fasciculata of the adrenal cortex (in the adrenal gland). ... tyrosine is the precursor of catecholamines epinephrine norepinephrine dopamine Synthesis Catecholamines are chemical compounds derived from the amino acid tyrosine containing catechol and amine groups. ... This article is about the urine of animals generally. ... Norepinephrine (INN)(abbr. ... The fight-or-flight response, also called hyperarousal or the acute stress response, was first described by Walter Cannon in 1915[1][2]. His theory states that animals react to threats with a general discharge of the sympathetic nervous system, priming the animal for fighting or fleeing. ... Corticotropin-releasing hormone (CRH), also called corticotropin-releasing factor (CRF) or corticoliberin, is a polypeptide hormone involved in the stress response. ... It has been suggested that HTPA be merged into this article or section. ... Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid hormones. ... The ‘’’glucocorticoid receptor’’’ (GR) is a ligand-activated intracytoplasmatic transcription factor that interacts with high affinity to cortisol and other glucocorticoids. ... Norepinephrine (INN)(abbr. ... Learning is the acquisition and development of memories and behaviors, including skills, knowledge, understanding, values, and wisdom. ...

Low cortisol levels may predispose individuals to PTSD; following war trauma, Swedish soldiers serving in Bosnia and Herzegovina with low pre-service salivary cortisol levels had a higher risk of reacting with PTSD symptoms, following war trauma, than soldiers with normal pre-service levels.^[10] Because cortisol is normally important in restoring homeostasis after the stress response, it is thought that trauma survivors with low cortisol experience a poorly contained—that is, longer and more distressing—response, setting the stage for PTSD. However, there is considerable controversy within the medical community regarding the neurobiology of PTSD and a review of existing studies on this subject showed no clear relation between cortisol levels and PTSD. Only a slight majority have found a decrease in cortisol levels while others have found no effect or even an increase.^[11] Homeostasis is the property of either an open system or a closed system, especially a living organism, which regulates its internal environment so as to maintain a stable, constant condition. ...

Neuroanatomy

In addition to biochemical changes, PTSD also involves changes in brain morphology. Combat veterans of the Vietnam war with PTSD showed an 8% reduction in the volume of their hippocampus in comparison with veterans who suffered no such symptoms.^{[citation needed]} For other uses, see Hippocampus (disambiguation). ...

In animal research as well as human studies, the amygdala has been shown to be strongly involved in the formation of emotional memories, especially fear-related memories. Neuroimaging studies in humans have revealed both morphological and functional aspects of PTSD. The amygdalocentric model of PTSD proposes that it is associated with hyperarousal of the amygdala and insufficient top-down control by the medial prefrontal cortex and the hippocampus. Further animal and clinical research into the amygdala and fear conditioning may suggest additional treatments for the condition. Filmed by PETA, Covance primate-testing lab, Vienna, Virginia, 2004-5. ... It has been suggested that this article or section be merged with functional neuroimaging. ... “Prefrontal” redirects here. ... For other uses, see Hippocampus (disambiguation). ... Fear conditioning is the method by which organisms learn to fear new stimuli. ...

Genetics

PTSD runs in families: For twin pairs exposed to combat in Vietnam, having a monozygotic (identical) twin with PTSD was associated with an increased risk of the co-twin having PTSD compared to twins that were dizygotic (non-identical twins).^[12] Because of the difficulty in performing genetic studies on a condition with a major environmental factor (ie., trauma), genetic studies of PTSD are in their infancy.

Diagnosis

The diagnostic criteria for PTSD, per the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as:^[1]

A. Exposure to a traumatic event

B. Persistent reexperience

C. Persistent avoidance of stimuli associated with the trauma

D. Persistent symptoms of increased arousal (e.g. difficulty falling or staying asleep or hypervigilance)

E. Duration of symptoms more than 1 month

F. Significant impairment in social, occupational, or other important areas of functioning

Notably, criterion A (the "stressor") consists of two parts, both of which must apply for a diagnosis of PTSD. The first (A1) requires that "the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others." The second (A2) requires that "the person’s response involved intense fear, helplessness, or horror." The DSM-IV-TR criterion differs substantially from the previous DSM-III-R stressor criterion, which specified the traumatic event should be of a type that would cause "significant symptoms of distress in almost anyone," and that the event was "outside the range of usual human experience." Since the introduction of DSM-IV, the number of possible PTSD traumas has increased and one study suggests that the increase is around 50%.^[13] Hypervigilance is an enhanced state of sensory sensitivity accompanied by an exaggerated intensity of behaviors whose purpose is to detect threats. ...

Treatment

Many forms of psychotherapy have been advocated for trauma-related problems such as PTSD. Basic counseling for PTSD includes education about the condition and provision of safety and support.^[14] Cognitive therapy shows good results,^[15] and group therapy may be helpful in reducing isolation and social stigma.^[16] The psychotherapy programs with the strongest demonstrated efficacy are all cognitive behavioral programs and include variants of exposure therapy, stress inoculation training (SIT), variants of cognitive therapy (CT), eye movement desensitization and reprocessing (EMDR), and combinations of these procedures.^[17] Exposure involves assisting trauma survivors to therapeutically confront distressing trauma-related memories and reminders in order to facilitate habituation and successful emotional processing of the trauma memory. Most exposure therapy programs include both imaginal confrontation with the traumatic memories and real-life exposure to trauma reminders. This article is about Becks Cognitive Therapy. ... Social stigma is severe social disapproval of personal characteristics or beliefs that are against cultural norms. ... Exposure Therapy is a cognitive behavioral therapy technique for reducing fear and anxiety responses, especially phobia. ...

Critical incident stress management

Early intervention after a traumatic incident, known as Critical Incident Stress Management (CISM) is often used to reduce traumatic effects of an incident, and potentially prevent a full-blown occurrence of PTSD. However recent studies regarding CISM seem to indicate iatrogenic effects.^[18][19] Six studies have formally looked at the effect of CISM, four finding that although patients and providers thought it was helpful, there was no benefit for preventing PTSD. Two other studies have indicated that CISM actually made things worse. Some benefit was found from being connected early to cognitive behavioral therapy, or for some medications such as propranolol. Effects of all these prevention strategies was modest.^[20] Critical Incident Stress Management is an adaptive short term helping process that focuses solely on an immediate and identifiable problem to enable the individual(s) affected to return to their daily routine(s) more quickly and with a lessened likelihood of experiencing post-traumatic stress disorder. ... Ancient Greek painting in a vase, showing a physician (iatros) bleeding a patient. ... Propranolol (INN) (IPA: ) is a non-selective beta blocker mainly used in the treatment of hypertension. ...

Eye movement desensitization and reprocessing

Eye Movement Desensitization and Reprocessing (EMDR) is specifically targetted as a treatment for PTSD.^[21] Research on EMDR is largely supported by those with the copyright for EMDR and third-party studies of its effectiveness are lacking, but a meta-analytic comparison of EMDR and cognitive behavioral therapy found both protocols indistinguishable in terms of effectiveness in treating PTSD.^[22] The references in this article would be clearer with a different and/or consistent style of citation, footnoting or external linking. ... A meta-analysis is a statistical practice of combining the results of a number of studies. ... A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. ...

Medication

Propranolol, a beta blocker which appears to inhibit the formation of traumatic memories by blocking adrenaline's effects on the amygdala, has been used in an attempt to reduce the impact of traumatic events.^[23] Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... Look up Amygdala in Wiktionary, the free dictionary. ...

Combination therapies

PTSD is commonly treated using a combination of psychotherapy (cognitive-behavioral therapy, group therapy, and exposure therapy are popular) and medications such as antidepressants (i.e. SSRI's such as fluoxetine and sertraline, SNRI's such as venlafaxine, and NaSSA's such as mirtazapine) or atypical antipsychotic drugs (such as quetiapine and olanzapine).^[24] Recently the anticonvulsant lamotrigine has been reported to be useful in treating some people with PTSD.^[25][26][27] The US Food and Drug Administration (FDA) recently approved a clinical protocol that combines the drug MDMA with talk therapy sessions.^[28] Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living. ... Cognitive therapy or cognitive behavior therapy is a kind of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of psychological disorder. ... Group therapy is a form of psychotherapy during which one or several therapists treat a small group of clients together as a group. ... Exposure Therapy is a cognitive behavioral therapy technique for reducing fear and anxiety responses, especially phobia. ... Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ... SSRI redirects here; for other uses, see SSRI (disambiguation). ... Prozac redirects here. ... Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... Serotonin Norepinephrine Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... Venlafaxine (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. ... Noradrenergic and specific serotonergic antidepressants (abbreviated: NaSSAs) are a relatively new class of antidepressants. ... Mirtazapine is an antidepressant introduced by Organon International in 1996 used for the treatment of mild to severe depression. ... The atypical antipsychotics (also known as second generation antipsychotics) are a class of prescription medications used to treat psychiatric conditions. ... Quetiapine (IPA: , kwe-TYE-a-peen), marketed by AstraZeneca with the brand name Seroquel, belongs to a series of neuroleptics known as atypical antipsychotics, which have, over the last two decades, become increasingly popular alternatives to typical antipsychotics, such as haloperidol. ... Olanzapine (oh-LAN-za-peen, sold as Zyprexa®, Zyprexa Zydis®, or in combination with fluoxetine, as Symbyax®) was the third atypical antipsychotic to gain approval by the Food and Drug Administration (FDA) and has become one of the most commonly used atypical antipsychotics. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... Lamotrigine (marketed as Lamictal (IPA: ) by GlaxoSmithKline, called Lamictin in South Africa, (Lamogine)[1] in Israel, and in South Korea) is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. ... “FDA” redirects here. ... MDMA (3,4-methylenedioxy-N-methylamphetamine), most commonly known today by the street name ecstasy, (often abbreviated to E, X, or XTC) is a semisynthetic empathogen-entactogen of the phenethylamine family. ...

Other techniques

Relationship based treatments are also often used.^[29] These, and other approaches, use attachment theory and an attachment model of treatment. In these cases, the treatment of complex trauma often requires a multi-modal approach. Mother and child Attachment theory is a psychological, evolutionary and ethological theory that provides a descriptive and explanatory framework for discussion of interpersonal relationships between human beings. ...

Epidemiology

PTSD may be experienced following any traumatic experience, or series of experiences which satisfy the criteria and that do not allow the victim to readily recuperate from the detrimental effects of stress. The National Comorbidity Survey Report provided the following information about PTSD in the general adult population: The estimated lifetime prevalence of PTSD among adult Americans is 7.8%, with women (10.4%) twice as likely as men (5%) to have PTSD at some point in their lives.^{[citation needed]} In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. ...

In recent history, catastrophes (by human means or not) such as the Indian Ocean Tsunami Disaster may have caused PTSD in many survivors and rescue workers. Today relief workers from organizations such as the Red Cross and the Salvation Army provide counseling after major disasters as part of their standard procedures to curb severe cases of post-traumatic stress disorder. The 2004 Indian Ocean earthquake, known by the scientific community as the Sumatra-Andaman earthquake,[1] was a great undersea earthquake that occurred at 00:58:53 UTC (07:58:53 local time) December 26, 2004 with an epicentre off the west coast of Sumatra, Indonesia. ... Red Cross redirects here. ... Shield of The Salvation Army The Salvation Army is a non-military evangelical Christian organisation. ...

There is debate over the rates of PTSD found in populations, but despite changes in diagnosis and the criteria used to define PTSD between 1997 and 2007, epidemiological rates have not changed significantly.^[2] Epidemiology is the study of factors affecting the health and illness of populations, and serves as the foundation and logic of interventions made in the interest of public health and preventive medicine. ...

History

Earliest reports

Reports of battle-associated stress appear as early as the 6th century BC.^[30] Although PTSD-like symptoms have also been recognized in combat veterans of many military conflicts since, the modern understanding of PTSD dates from the 1970s, largely as a result of the problems that were still being experienced by Vietnam veterans.^[30] For other uses of War, see War (disambiguation). ...

The term post-traumatic stress disorder or PTSD was created in the mid 1970s.^[30] Early in 1978, the term was used in a working group finding presented to the Committee of Reactive Disorders.^[31] The term was formally recognised in 1980.^[30] (In the DSM-IV, which is considered authoritative, the spelling "posttraumatic stress disorder" is used. Elsewhere, "posttraumatic" is often rendered as two words — "post-traumatic stress disorder" or "post traumatic stress disorder" — especially in less formal writing on the subject.)

Veterans and politics

The diagnosis was removed from the DSM-II, which resulted in the inability of Vietnam veterans to receive benefits for this condition. In part through the efforts of anti vietnam war activists and the anti war group Vietnam Veterans Against the War and Chaim F. Shatan, who worked with them and coined the term post-Vietnam Syndrome, the condition was added to the DSM-III as posttraumatic stress disorder.^[31] Vietnam Veterans Against the War (VVAW) is a tax-exempt Non-profit organization and corporation, originally created to oppose the Vietnam War. ... Chaim F. Shatan was born in Wloclawek, Poland on September 1, 1924. ...

In the United States, the provision of compensation to veterans for PTSD is under review by the Department of Veterans Affairs (VA). The review was begun in 2005 after the VA had noted a 30% increase in PTSD claims in recent years. The VA undertook the review because of budget concerns and apparent inconsistencies in the awarding of compensation by different rating offices. The United States Department of Veterans Affairs (VA) is a government-run military veteran benefit system with Cabinet-level status. ...

This led to a backlash from veterans'-rights groups, and to some highly-publicized suicides by veterans who feared losing their benefits, which in some cases constituted their only income. In response, on November 10, 2005, the Secretary of Veterans Affairs announced that "the Department of Veterans Affairs (VA) will not review the files of 72,000 veterans currently receiving disability compensation for post-traumatic stress disorder..."^[32]

The diagnosis of PTSD has been a subject of some controversy due to uncertainties in objectively diagnosing PTSD in those who may have been exposed to trauma, and due to this diagnosis' association with some incidence of compensation-seeking behavior.^[33] Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event. ... Incidence is a measure of the risk of developing some new condition within a specified period of time. ...

The social stigma of PTSD may result in under-representation of the disorder in military personnel, emergency service workers and in societies where the specific trauma-causing event is stigmatized (i.e. sexual assault).^[2] Social stigma is severe social disapproval of personal characteristics or beliefs that are against cultural norms. ... Emergency services are public services that deal with emergencies and other aspects of Public Safety. ... Sexual assault is any physical contact of a sexual nature without voluntary consent. ...

Canadian veterans

Veterans Affairs Canada is a new program including rehabilitation, financial benefits, job placement, health benefits program, disability awards and family support.^[34] Prevalent image on VAC posters during 2005, the Year of the Veteran. ...

Cultural references

In recent decades, with the concept of trauma, and PTSD in particular, becoming just as much a cultural phenomenon as a medical or legal one, artists have begun to engage the issue in their work. Many movies deal with PTSD. It is an especially popular subject amongst "war veteran" films, often portraying Vietnam war veterans suffering from extreme PTSD and having difficulties adjusting to civilian life. For other uses see film (disambiguation) Film refers to the celluliod media on which movies are printed Film — also called movies, the cinema, the silver screen, moving pictures, photoplays, picture shows, flicks, or motion pictures, — is a field that encompasses motion pictures as an art form or as part of...

In more recent work, an example is that of Krzysztof Wodiczko who teaches at MIT and who is known for interviewing people and then projecting these interviews onto large public buildings.^[35] Wodiczko aims to bring trauma not merely into public discourse but to have it contest the presumed stability of cherished urban monuments. His work has brought to life issues such as homelessness, rape, and violence. Other artists who engage the issue of trauma are Everlyn Nicodemus of Tanzania and Milica Tomic of Serbia.^[36] Krzysztof Wodiczko is an artist teaching currently living in Boston and teaching at MIT. He was born in 1943 in Warsaw, Poland and graduated from the Academy of Fine Arts in 1968 with a degree in industrial design and taught at the Warsaw Polytechnic until 1977. ... Mapúa Institute of Technology (MIT, MapúaTech or simply Mapúa) is a private, non-sectarian, Filipino tertiary institute located in Intramuros, Manila. ...

George Carlin makes reference to the various incarnations of PTSD terminology on his Parental Advisory: Explicit Lyrics CD/DVD:
I don't like words that hide the truth. I don't like words that conceal reality. I don't like euphemisms, or euphemistic language. And American English is loaded with euphemisms. Cause Americans have a lot of trouble dealing with reality. Americans have trouble facing the truth, so they invent the kind of a soft language to protect themselves from it, and it gets worse with every generation. For some reason, it just keeps getting worse. I'll give you an example of that. There's a condition in combat. Most people know about it. It's when a fighting person's nervous system has been stressed to it's absolute peak and maximum. Can't take anymore input. The nervous system has either (click) snapped or is about to snap. In the first world war, that condition was called shell shock. Simple, honest, direct language. Two syllables, shell shock. Almost sounds like the guns themselves. That was seventy years ago. Then a whole generation went by and the second world war came along and very same combat condition was called battle fatigue. Four syllables now. Takes a little longer to say. Doesn't seem to hurt as much. Fatigue is a nicer word than shock. Shell shock! Battle fatigue. Then we had the war in Korea, 1950. Madison avenue was riding high by that time, and the very same combat condition was called operational exhaustion. Hey, were up to eight syllables now! And the humanity has been squeezed completely out of the phrase. It's totally sterile now. Operational exhaustion. Sounds like something that might happen to your car. Then of course, came the war in Viet Nam, which has only been over for about sixteen or seventeen years, and thanks to the lies and deceits surrounding that war, I guess it's no surprise that the very same condition was called post-traumatic stress disorder. Still eight syllables, but we've added a hyphen! And the pain is completely buried under jargon. Post-traumatic stress disorder. I'll bet you if we'd of still been calling it shell shock, some of those Viet Nam veterans might have gotten the attention they needed at the time. I'll betcha. I'll betcha.^[37] George Denis Patrick Carlin[15] (born May 12, 1937) is a Grammy-winning American stand-up comedian, actor, and author. ...

See also

• Acute stress reaction
• Complex post-traumatic stress disorder
• Dissociative disorders
• Emotional dysregulation
• Post-abduction syndrome
• Post-abortion syndrome
• Psychogenic amnesia
• Psychoneuroimmunology
• Survivor syndrome
• Trauma model of mental disorders

Acute stress reaction is a psychological condition arising in response to a terrifying event. ... Complex post-traumatic stress disorder (C-PTSD) is a clinically recognized condition that results from extended exposure to prolonged social and/or interpersonal trauma, including instances of physical abuse, emotional abuse, sexual abuse (including sexual abuse during childhood), domestic violence, torture, chronic early maltreatment in a caregiving relationship, and war. ... Dissociative disorders are defined as conditions that involve disruptions or breakdowns of memory, awareness, identity and/or perception. ... Emotional dysregulation (or affect dysregulation) is a term used in the mental health community to refer to an emotional response that is not well modulated. ... // Post-abduction Syndrome (PAS), also sometimes called Post-abduction Stress Syndrome (PASS), is a collection of symptoms commonly reported by persons who claim they have been the victim of an alien abduction. ... Issues of discussion Post-abortion syndrome (PAS), post-traumatic abortion syndrome and abortion trauma syndrome, are terms used by opponents of abortion[1][2] to describe a proposed diagnosis of psychopathological characteristics which are proposed to occur in some women following a therapeutic abortion. ... Psychogenic Amnesia is a form of amnesia popularized by popular culture, particularly film. ... Psychoneuroimmunology (PNI) investigates the relations between the psychophysiological and immunophysiological dimensions of living beings. ... Survivor syndrome (also KZ syndrome) is a phrase which has been used to describe the set of shared reactions and behaviors of people who have survived a massive and adverse event, such as the Holocaust in Nazi Germany. ... The “Trauma model” of mental disorders is an expression coined by psychiatrist Colin Ross as a solution to the problem of comorbidity in the mental health field. ...

References

2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 71st day of the year (72nd in leap years) in the Gregorian calendar. ... David Satcher David Satcher (b. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 90th day of the year (91st in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 68th day of the year (69th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 77th day of the year (78th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 121st day of the year (122nd in leap years) in the Gregorian calendar. ... The Washington Post is the largest newspaper in Washington, D.C.. It is also one of the citys oldest papers, having been founded in 1877. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... December 27 is the 361st day of the year in the Gregorian calendar (362nd in leap years). ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance to the Gregorian calendar. ... is the 71st day of the year (72nd in leap years) in the Gregorian calendar. ... Mark Jarzombek is a US-born author and architectural historian, and (since 1995) Director of the History Theory Criticism Section of the Department of Architecture at MIT, Cambridge MA, USA. Jarzombek received his architectural training at the ETH Zurich, where he graduated in 1980. ...

External links

• Posttraumatic stress disorder at the Open Directory Project