PTSD: Diagnosis and Treatment

About this course

Posttraumatic stress disorder (PTSD) is a syndrome that results from exposure to real or threatened death, serious injury, or sexual assault. The symptoms of PTSD include persistently re-experiencing the traumatic event, intrusive thoughts, nightmares, flashbacks, dissociation, intense negative emotions such as sadness and guilt, and physiological reactions when exposed to the traumatic reminder. Having awareness regarding the signs and symptoms of PTSD is essential for healthcare professionals to start early treatment and limit the burden of the illness on the person who suffers from PTSD.

Learning objectives

• Define posttraumatic stress disorder (PTSD)
• Describe the symptoms of PTSD
• Identify diagnostic tools for PTSD that may be used by healthcare professionals and mental health experts.
• Review various psychotherapies and medication classifications to treat PTSD

Course outline

25 sections · finish in any order across devices

1. 1

   Introduction

   Posttraumatic stress disorder (PTSD) is a syndrome that results from exposure to real or threatened death, serious injury, or sexual assault.¹ Following the traumatic event, PTSD is common and is one of the serious health concerns that is associated with comorbidity, functional impairment, and incre

   4 min

2. 2

   Pathophysiology Related to PTSD

   Posttraumatic stress disorder occurs in approximately 5% to 10% of the population who has a traumatic experience, and the percentage is higher in women than in men.¹⁷ Studies have shown that the rates vary depending on the specific population being considered. ¹⁷

   4 min

3. 3

   Diagnosing PTSD

   The initial step in the diagnosis of posttraumatic stress disorder is to obtain a detailed history. It may be challenging for the individual to describe the nature and severity of the traumatic event, and they may choose to avoid mentioning it. However, the presentation and the duration of the sympt

   4 min

4. 4

   Criterion A: Stressor

   Exposure to real or threatened death, injury, or sexual violence in one or more of the following ways:

   4 min

5. 5

   Criterion B: Intrusion Symptoms

   Presence of one or more of the following symptoms related to the traumatic event that began after the trauma occurred:

   4 min

6. 6

   Criterion D: Negative Alterations in Mood

   Negative alterations in mood and cognition that began or worsened after the traumatic event, as evidenced by two or more of the following:

   4 min

7. 7

   Conducting a Mental Health Exam

   Posttraumatic stress disorder is a complex phenomenon, and it is necessary to evaluate for any co-existing psychiatric illnesses that an individual may have. After a detailed history is obtained, the next step is to have a thorough mental status examination, which helps confirm the behavioral, emoti

   4 min

8. 8

   The Primary Care PTSD Screen for DSM-5

   The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) is a 5-item screen that is used in primary care settings to identify people who may have PTSD. The measure begins with an item that assesses whether an individual has had any exposure to traumatic events by stating:

   4 min

9. 9

   SPAN Self-Report Screen

   The SPAN (startle, physically upset by reminders, anger, and numbness) Self-Report Screen is a four-item screen that assists in identifying PTSD. The four items are ranked on a Likert scale to assess levels of distress within a 7 day period, and anyone who has a positive screen result should then be

   4 min

10. 10

    The SPRINT Self-Report Screen

    The SPRINT Self-Report Screen (Short Post-Traumatic Stress Disorder Rating Interview) is an eight-item self-report measure that assesses the core symptoms of PTSD (intrusion, avoidance, numbing, arousal), somatic malaise, stress vulnerability, and role and social functional impairment. The symptoms

    4 min

11. 11

    Trauma Screening Questionnaire

    The Trauma Screening Questionnaire (TSQ) is a 10-item symptom screen that used for survivors of traumatic events. The TSQ has five re-experiencing items and five arousal items. Individuals who answer the questionnaire should endorse any symptoms that they have experienced at least twice within a 7 d

    4 min

12. 12

    Clinician-Administered PTSD Scale for DSM-5 (CAPS-5)

    The CAPS is the gold standard in PTSD assessment.¹⁰ The CAPS-5 is a 30-item structured interview that can be used to:

    4 min

13. 13

    PTSD Checklist for DSM-5

    The PTSD Checklist for DSM-5 (PCL-5) is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD. The PCL-5 has a variety of purposes, including²:

    4 min

14. 14

    Trauma Symptom Checklist - 40 (TSC-40)

    The TSC-40 is a 40-item self-report measure of symptomatic distress in adults arising from childhood or adult traumatic experiences. It measures aspects of post-traumatic stress as well as other symptoms found in some traumatized people, children, and their families through evaluation on a Likert sc

    4 min

15. 15

    Treatment Considerations for PTSD

    Posttraumatic stress disorder is a disabling consequence after a traumatic event, and early detection and intervention is necessary for planning the appropriate treatment. Studies have shown that both psychotherapy and pharmacotherapy are effective. ⁹˒¹³ Trauma-focused psychotherapy is considered a

    4 min

16. 16

    Trauma-Focused Cognitive Behavioral Therapy

    Trauma-Focused Cognitive Behavioral Therapy, or TF-CBT, is an evidence-based treatment program intended to help children and their families deal with the aftermath of a traumatic experience.⁹˒¹³ Trauma-Focused Cognitive Behavioral Therapy is also relatively short-term, lasting no more than 16 sessio

    4 min

17. 17

    Eye Movement Desensitization and Reprocessing (EMDR)

    Eye movement desensitization and reprocessing (EMDR) is a treatment for PTSD as well as other mental health conditions. ⁶ The treatment combines one’s traumatic memories and positive thoughts and beliefs to help reduce the distress stemming from the traumatic event. With these thoughts and images in

    4 min

18. 18

    Cognitive Processing Therapy

    Cognitive processing therapy (CPT) is a specific type of cognitive behavioral therapy that has been effective in reducing symptoms of PTSD that have developed after experiencing a variety of traumatic events including child abuse, combat, rape ,and natural disasters. ⁹Cognitive processing therapy is

    4 min

19. 19

    Imaginal Exposure

    Exposure to a traumatic event through imaging allows the individual to re-experience the event in a safe, controlled environment while also carefully experiencing their reactions and beliefs in relation to that event. In imaginal exposure, the main clinical issue is avoidance. Exposure therapy corre

    4 min

20. 20

    Serotonin Reuptake Inhibitors (SRIs)

    Serotonin reuptake inhibitors (SRIs) include selective serotonin reuptake inhibitors (SSRIs) that work by increasing serotonin levels in the brain, which influences emotions, mood, and sleep, and Serotonin and norepinephrine reuptake inhibitors (SNRIs) which work by reducing the absorption of seroto

    4 min

21. 21

    Second-Generation Antipsychotics (SGAs)

    Second-Generation Antipsychotics (SGAs) can be used either as monotherapy or in combination with Serotonin reuptake inhibitors. Second-generation antipsychotics are mainly used to manage psychosis in someone who has lost touch with reality or is experiencing auditory or visual hallucinations, or del

    4 min

22. 22

    Pharmacology Considerations

    Serotonin Reuptake Inhibitors (SRIs) can cause rapid, chaotic heartbeats associated with long QT-syndrome, syndrome of inappropriate antidiuretic hormone secretion, hyponatremia, suicide ideation (especially in children), seizures, increased risk of bleeding, sexual dysfunction, gastrointestinal sym

    4 min

23. 23

    Conclusion

    Posttraumatic stress disorder often poses a diagnostic dilemma. A detailed history from the individual may suggest that they have PTSD; however, detailed mental status examination, cognitive testing, and laboratory investigations are essential to rule out any coexisting medical or psychiatric illnes

    4 min

24. 24

    PTSD: Diagnosis and Treatment Posttest

    Posttraumatic stress disorder (PTSD) is a syndrome that results from exposure to real or threatened death, serious injury, or sexual assault.

    4 min

25. 25

    PTSD: Diagnosis and Treatment Posttest Answers

    Posttraumatic stress disorder (PTSD) is a syndrome that results from exposure to real or threatened death, serious injury, or sexual assault.

    5 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

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• Wang, Z., Zhu, H., Yuan, M., Li, Y., Qiu, C., Ren, Z., … Zhang, W. (2020). The resting-state functional connectivity of amygdala subregions associated with post-traumatic stress symptom and sleep quality in trauma survivors. European Archives of Psychiatry and Clinical Neuroscience. doi:10.1007/s00406-020-01104-3
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