Anxiety Disorders PTSD
In this paper I will discuss the multitude of issues faced by clinicians in assessing and diagnosing Post Traumatic Stress Disorder (PTSD). I will attempt to explore the many factors which influence the occurrence and manifestation of PTSD. I will critically discuss this question by exploring the nature of anxiety, the relationship between anxiety and PTSD, how PTSD is influenced by different life-stages, cultural influences impacting on PTSD, the nature of traumatic events and how this differs for war veterans and children exposed to violence. Finally, I will explore the difficulties in differentiating PTSD and other pre-morbid and co-morbid psychological disorders. The Nature of Anxiety
Epstein (cited in Dobson, 1985, p. 308) noted that “anxiety may eventuate from the perception of threat; threats to future happiness, threats to self-esteem, and threats to the individual’s ability to make sense of the data of his experience.” Anxiety describes the physical, mental and behavioural changes that allow you to deal with threat or danger. Any threats that occur in everyday life cause a series of changes to occur automatically in the body, preparing it for fight- or- flight. This fight or flight response is associated with physical and mental changes. The experience of anxiety is normal and moderate levels of anxiety can improve performance and assist individuals to function optimally. However, when anxiety becomes severe it is not helpful and can eradicate our capacity to absorb new information, plan an appropriate response and carry out activities. Anxiety is a common feature in anxiety disorders as well as in many other psychological disorders.
In terms of the literature on anxiety in children, Mashe and Wolfe (2010) observed that all children experience anxiety, worry & fear as a normal part of growing up and this may be common and age appropriate. However when it becomes excessive and debilitating, then it becomes an anxiety disorder. Bittner, Egger, Erkanli, Costello, Foley and Angold (2007) point out that it was originally believed that anxiety in children was thought to be transitionary and benign and would fade over time. However, we now know that childhood experience of anxiety may exacerbate and lead to other issues during adolescence and adulthood. The Relationship between Anxiety and PTSD
The Diagnostic and Statistical Manual of Mental Disorders ,DSM-IV, (2000), is a manual published by the American Psychiatric Association and includes all currently recognized mental health disorders. Post Traumatic Stress Disorder (PTSD) is classified under Anxiety Disorders. One of the first steps in the treatment of anxiety disorders is accurate assessment and diagnosis about the nature of the disorder and the symptoms of anxiety that are experienced. The diagnosis of PTSD requires symptoms of at least one month duration. PTSD is characterised by the development of a long-lasting anxiety response following a traumatic or catastrophic event. Typically, the individual experiences or witnesses a traumatic event such as actual or threatened death, serious injury to oneself or another person, or a threat to the personal integrity of oneself or others. A new addition to the criteria for PTSD, provided in DSM-1V, is the stipulation that the individual’s reaction to trauma exposure is one of extreme fear, helplessness, or horror. Keane, Taylor and Penk (1997) observe that diagnostic criteria for classifying PTSD can be difficult. PTSD shares many symptoms with other disorders that it becomes challenging to demonstrate the uniqueness of PTSD. They also point
out that PTSD, particularly untreated may lead to other disorders, thus complicating differential diagnosis because it is hard to separate original PTSD symptoms from later issues. According to the International Statistical Classification of Diseases and Related Health Problems (2007),...