What are trauma- and stressor-related disorders?

For some individuals, exposure to traumatic or stressful life events leads to problems with anxiety and other distressing emotions (i.e., sadness, grief, loss, disgust) and symptoms (i.e., intrusive thoughts and memories about the trauma, physical and emotional reactivity to trauma-related cues, avoidance of situations that are related to the trauma). Although the majority of people who are exposed to traumatic events recover over time and do not develop ongoing problems, many do and benefit significantly from appropriate treatment. Decades of research have shown that trauma-related symptoms can be effectively treated, even many years after traumas have occurred. Our staff have considerable experience treating individuals who have experienced a wide range of traumatic and stressful events and we provide state-of-the art treatments for trauma-related symptoms.

Below are brief descriptions of the types of trauma- and stressor-related disorders we treat at the Anxiety Center.

Posttraumatic stress disorders (PTSD)

PTSD can develop after individuals experience events that involve actual or threatened serious injury, death, or sexual violence. Symptoms of PTSD can develop related to these experiences if individuals have experienced them directly, witnessed these events happening to others, learned about these events happening to loved ones, or had repeated exposure to the details of these types of events (i.e., first responders, police officers).  Common types of traumas that are linked to PTSD symptoms include serious accidents, physical assault or abuse, military combat, natural disasters, terrorist incidents, and sexual assault or abuse.

Individuals with PTSD experience at least some of each of four different types of symptoms:

(1) Intrusive thoughts/feelings related to the trauma, including distressing memories of the trauma, distressing dreams related to the trauma, flashbacks in which the person feels that they are reliving the trauma, and intense physical and/or psychological reactions and distress to cues that are related to the trauma (situations, places, feelings, body sensations, etc.);

(2) Avoidance of things associated with the trauma, including efforts to avoid memories, thoughts and feelings about the trauma, as well as avoiding external reminders of the event (i.e., people, places, objects, talking about the event);

(3) Negative changes in cognition and mood related to the trauma, including difficulties remembering parts of the traumatic event, strong negative beliefs about self/others/the world, feelings of self-blame, negative emotion states (fear, horror, anger, guilt), decreased interest in important activities, feeling detached from others, and difficulties experiencing positive emotions (love, joy);

(4) Changes in physical reactivity/arousal related to the trauma, including increased irritability/anger, exaggerated startle response, hypervigilance, concentration problems, sleep problems, and self-destructive behaviors

Symptoms that persist in each of these categories for more than 1 month following a traumatic event may indicate a diagnosis of PTSD. In some people, symptoms of PTSD do not begin for 6 months or more following a traumatic event. The significant emotional, cognitive, and behavioral changes that can occur with PTSD are often very challenging to live with and can greatly impair functioning and quality of life.

Acute stress disorder (ASD)

Symptoms of ASD are very similar to those of PTSD, with some minor exceptions, and a diagnosis is given if symptoms are present between 3 days and 1 month following a traumatic event. For some people, symptoms of ASD will decrease after a few weeks and will not persist. For others, the symptoms continue for longer than 1 month after the trauma and a diagnosis of PTSD may then be appropriate.

Adjustment disorders

Many individuals develop emotional or behavior problems following other stressful live events that are not included in the diagnoses of PTSD and ASD. Examples of these types of stressors include marital problems, a relationship break-up or divorce, job-related difficulties or losing a job, illnesses that lead to increasing levels of disability, living in areas of high crime, etc. Adjustment disorders are diagnosed when symptoms that develop in response to these types of events involve marked distress that is greater than expected and also lead to impairment in important areas of functioning. Adjustment disorder reactions can involve predominant feelings of anxiety and/or depression, as well as changes in conduct.