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Anxiety Disorders in AdultsA Clinical Guide$
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Vladan Starcevic, MD, PhD

Print publication date: 2009

Print ISBN-13: 9780195369250

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195369250.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 08 December 2021

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder

(p.293) Chapter 7 Posttraumatic Stress Disorder
Anxiety Disorders in Adults

Vladan Starcevic, MD, PhD

Oxford University Press

Posttraumatic stress disorder (PTSD) develops in predisposed individuals who have had a traumatic experience. There are many different ways in which PTSD presents itself, and only some of them(e.g., avoidance behavior, symptoms of hyperarousal)make it look like other anxiety disorders. Various manifestations of PTSD have led to its also being considered primarily a disorder of memory, a dissociative disorder, or a condition more closely related to depression. Given the presumed etiological link between a traumatic event and PTSD, there is a rare opportunity among psychiatric disorders for implementation of strategies that might prevent the development of PTSD. Most people recover after trauma, while many of those who do develop PTSD remit spontaneously. Still, a proportion of traumatized people develop a chronic form of PTSD–a condition that is often very difficult to treat. Posttraumatic stress disorder has been a controversial entity since its official introduction in the psychiatric classification in 1980.Anumber of issues have arisen, and many of them remain unresolved. Some of the key questions are listed below…. 1. Is the concept of PTSD too heterogeneous? 2. Are there different types of PTSD or different disorders arising in the aftermath of trauma? 3. Has the concept of a traumatic event become too broad? Alternatively, can a greater variety of stressful events precipitate PTSD? 4. Is the occurrence of trauma necessary for the development of PTSD? 5. Are there any specific or unique features of PTSD, which would allow its differentiation from related disorders? 6. Has the concept of PTSD been overused or misused, especially in the context of compensation claims and litigation? Does PTSD reflect a ‘‘medicalization’’ of the normal human reactions and emotions in response to trauma? 7. What accounts for the fact that the majority of trauma victims recover spontaneously from early PTSD-like symptoms, whereas some go on to develop a chronic, severe, and debilitating PTSD? Has there been too much emphasis on vulnerability to developing post-trauma psychopathology and too little attention paid to factors such as resilience? 8. Why do we still have a difficulty understanding what combination of risk factors best predicts the development of PTSD?

Keywords:   Acute stress disorder, Borderline personality disorder, Carbamazepine, Defense mechanisms, Eszopiclone, Flashbacks, Guilt feelings, Habituation, Impulse control disorders, Kindling

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