There are several criteria that must be met for an individual to receive a clinical diagnosis of post-traumatic stress (PTSD). According to the current version of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV), an individual must have experienced or witnessed a threat of death or injury to himself/herself or someone else, and this event must elicit responses of helplessness, intense fear, or horror. The DSM-V intends to remove these criteria based on evidence that these reactions to the described events do not necessarily predict the development of PTSD. However, some researchers and mental health professionals believe that the reactions of helplessness, fear, and horror are more predictive of PTSD than the traumatic experience itself.
To determine how each of these criteria influence PTSD, Patricia K. Kerig of the Department of Psychology at the University of Utah recently conducted a study that examined all of these symptoms in 555 juvenile offenders who had been exposed to trauma. The adolescents were evaluated for symptom severity and the presence of the three criteria. Kerig found that there was a direct relationship between feelings of helplessness and PTSD. She also discovered that confusion and disorganized behavior, often seen as peritraumatic symptoms, were more strongly associated with PTSD than the symptoms of fear and horror.
The study also identified a distinction between how the female survivors expressed peritraumatic symptoms when compared to the male survivors. With respect to numbing, the male participants demonstrated numbing reactions through helplessness, while the female participants used dissociation as a method of numbing. Kerig believes that because women often experience trauma at the hands of family members, dissociation could be their way of protecting their attachment to their abuser. This study shows that there are a number of ways in which individuals express PTSD and that these manifestations can vary by age, gender and experience. “Therefore, these results suggest the importance of continuing to develop developmentally sensitive and empirically based indices of PTSD in young people,” Kerig said.
Kerig, P. K., Bennett, D. C. (2012). Beyond fear, helplessness, and horror: Peritraumatic reactions associated with posttraumatic stress symptoms among traumatized delinquent youth. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. doi: 10.1037/a0029609
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