Post-Traumatic Stress Disorder [Integral Eye Movement Therapy (IEMT) Wiki]

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.
====== Post-Traumatic Stress Disorder ======

Post-traumatic stress disorder (PTSD) can develop after exposure to traumatic events. Many people experience distress after trauma without developing PTSD. The diagnosis concerns a particular pattern, duration and impact of symptoms, assessed in context. A person's self-description is a starting point for understanding their concerns, not grounds for dismissing them or assuming a diagnosis.

In DSM-5 and DSM-5-TR, PTSD is classified among **trauma- and stressor-related disorders**. It is no longer grouped with anxiety disorders as it was in DSM-IV. See the [[https://www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp|National Center for PTSD's account of the DSM criteria]].

===== Video: a brief introduction to PTSD =====

{{youtube>dRYBfsdO2is?large}}

[[https://www.youtube.com/watch?v=dRYBfsdO2is|What is PTSD?]] — **Veterans Health Administration / National Center for PTSD** (30 seconds). An accessible introduction to the four broad symptom groups, with a route to further information from the National Center for PTSD. This is general clinical background, not a diagnostic assessment or evidence for IEMT as a PTSD treatment.

===== Diagnostic Criteria =====

For adults and children older than six, the DSM framework includes a qualifying exposure to actual or threatened death, serious injury or sexual violence, followed by symptoms across four groups:

^ Symptom group ^ Examples ^
| Intrusion | Unwanted memories, nightmares or flashbacks. |
| Avoidance | Avoiding trauma-related thoughts, feelings or reminders. |
| Changes in cognition and mood | Persistent negative beliefs, detachment or reduced interest. |
| Changes in arousal and reactivity | Hypervigilance, exaggerated startle, irritability or sleep difficulties. |

The minimum symptom counts are one intrusion symptom, one avoidance symptom, two cognition/mood symptoms and two arousal/reactivity symptoms. Symptoms must persist for more than a month, cause significant distress or impairment, and not be attributable to a substance or another medical condition. Exposure criteria and exclusions matter; this outline is not a diagnostic checklist. Younger children have a modified set of criteria. See [[https://www.veterans.gc.ca/en/mental-and-physical-health/mental-health-and-wellness/compensation-illness-or-injury/disability-benefits/entitlement-eligibility-guidelines/az-index/post-traumatic-stress-disorder-ptsd|Veterans Affairs Canada's DSM-5-TR criteria set]], the [[https://www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp|National Center for PTSD clinical overview]] and [[the_diagnostic_statistical_manual_and_the_icd|the wiki's DSM and ICD page]].

===== Complex Post-Traumatic Stress Disorder (CPTSD) =====

**ICD-11 recognises complex PTSD as a distinct diagnosis.** It includes the core PTSD features together with persistent difficulties in regulating emotion, a negative sense of self, and difficulties sustaining relationships. DSM-5-TR does not have a separate CPTSD diagnosis. The two classification systems should not be combined into a single checklist.

Prolonged or repeated trauma is relevant to many people's histories, but the label cannot be assigned from the event type alone. The [[https://www.ptsd.va.gov/professional/treat/essentials/complex_ptsd.asp|National Center for PTSD's history and definitions of complex PTSD]] explains the distinction and the development of the concept.

===== Shell Shock =====

“Shell shock” was a First World War term covering varied symptoms and explanations. Historical case records cannot all be retrospectively equated with present-day PTSD. The [[https://www.nationalarchives.gov.uk/education/resources/medicine-on-the-western-front-part-two/war-office-report-on-shell-shock/|National Archives' War Office report extracts]] show contemporary uncertainty about causes and classification. A [[https://pmc.ncbi.nlm.nih.gov/articles/PMC4176276/|study of Queen Square hospital case records]] also documents the diversity of presentations.

{{youtube>IWHbF5jGJY0?}}

**Historical footage:** the existing film is retained as historical context. It is not a demonstration of current diagnostic criteria or evidence that all people shown had the same condition.

===== Military and Civilian Contexts =====

PTSD can affect veterans and civilians. Experiences of violence, abuse, disasters and other qualifying events may be relevant. Military service, homelessness or a difficult transition to civilian life is not itself a PTSD diagnosis. Housing needs, physical health, relationships and substance use deserve attention in their own right rather than being attributed automatically to one disorder.

===== Alcohol and Other Co-occurring Difficulties =====

PTSD can coexist with depression, anxiety and substance-use disorders. The [[https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd|NIMH PTSD overview]] discusses these overlapping difficulties. Assessment and planning should consider them together. A single prevalence percentage should not be applied across all populations, settings or definitions of alcohol use.

===== Treatment and the Place of IEMT =====

[[https://www.nice.org.uk/guidance/ng116/chapter/recommendations|NICE guideline NG116]] recommends trauma-focused psychological treatments, including trauma-focused CBT and EMDR under specified circumstances. The recommendations depend on age, timing, symptoms and clinical circumstances. IEMT and EMDR are different approaches; evidence or recommendations for EMDR cannot simply be transferred to IEMT.

This page supplies clinical background, not evidence establishing IEMT as a PTSD treatment. Within the wiki's proposed [[adaptive_formulation|adaptive formulation framework]], record the person's priorities, functioning, existing care, agreed scope and review arrangements. Distinguish a session-level change in distress from a diagnostic conclusion or sustained recovery, and coordinate assessment or referral where the person's needs exceed the practitioner's competence.

{{tag>Related ptsd trauma diagnosis}}