When people are faced with a life-threatening experience, they focus on survival and self-protection. When their usual coping systems fail, they tend to turn to their environment to supply the resources they lack themselves. The quantity and quality of coping resources available depends on the maturity of the nervous system, as well as prior experience and training. Children and exhausted adults are more prone to develop lasting trauma symptomatology than youngsters who live in a protective family, or adults who are well prepared (such as physicians, fire fighters or police personnel). In the immediate aftermath of a traumatic event, victims may respond with a mixture of numbness, withdrawal, confusion, shock, and speechless terror. Some cope by taking action, while others dissociate. Neither response predictably prevents or fosters the subsequent development of PTSD, though being able to maintain an internal locus of control, and utilizing problem-focused coping significantly reduces the chance of developing PTSD. In contrast, dissociation, losing track of what is going on, and losing affective and cognitive engagement with the environment is an important predictor for the development of subsequent PTSD (Shalev et al., 1996). The longer the traumatic experience lasts, the more likely the victim is to react with dissociation.

The formal diagnosis of PTSD is characterized by three major elements:

1. The repeated reliving of memories of the traumatic experience. These tend to involve intense sensory and visual memories of the event that often are accompanied by extreme physiological and psychological distress, and sometimes by a feeling of emotional numbing, during which there usually is no physiological arousal. These intrusive memories may occur spontaneously or can be triggered by a range of real and symbolic stimuli.

2. Avoidance of reminders of the trauma, as well as of emotional numbing. Detachment and emotional blunting often coexist with intrusive recollections. This is associated with an inability to experience joy and pleasure, and with a general withdrawal from engagement with one's surroundings. Over time, these features may become the dominant symptoms of PTSD.

3. The third element of PTSD consists of a pattern of increased arousal, as expressed by hypervigilance, irritability, memory and concentration problems, sleep disturbances, and an exaggerated startle response. In the more chronic forms of the disorder, this pattern of hyperarousal and avoidance may be the dominant clinical features. Hyperarousal causes traumatized people to become easily distressed by unexpected stimuli. Their tendency to be triggered into reliving traumatic memories illustrates how their perceptions become excessively focused on the involuntary seeking out of the similarities between the present and their traumatic past. As a consequence, many neutral experiences become reinterpreted as being associated with the traumatic past.

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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