POST TRAUMATIC STRESS DISORDER (PTSD)

Main features

Exposure to a traumatic event that involved a major threat, or horror
The traumatic event is re-experienced
Persistent avoidance of any stimuli associated with the event.
Persistent symptoms of increased arousal (not present before the trauma)

In pregnancy/postnatal

PTSD and PND are distinct but may overlap. Common to both are a feeling of foreshortened future, sleep disturbance, and difficulty concentrating. Sometimes women are misdiagnosed or diagnosed with depression but the PTSD is missed (both need to be treated).
Many women with a history of childhood sexual abuse may experience high anxiety regarding internal examinations or childbirth. Some literature suggests that previous trauma may predispose women to traumatic birth experience.
Women may be fearful and avoidant of the baby (as the infant may be a reminder of traumatic experience).
Treatment often takes much longer, may progress at a much slower rate, and requires a sensitive and structured treatment program from a mental health professional with specific training in PTSD.
A growing number of authors recognise a syndrome called Complex PTSD which is usually the result of chronic recurrent neglect or abuse during childhood (see Wikipaedia for fuller description)
Women with Complex PTSD are often diagnosed with depressive disorders, personality disorders or dissociative disorders

See information for women on Post Traumatic Stress Disorder.

Core Features of PTSD (In adults)

Core symptoms

(i) Exposure: Person experienced exposure to a traumatic event that involved actual or threatened death or serious injury and the persons response involved intense fear, helplessness, or horror.

(ii) Persistent re-experiencing of:

recurrent and intrusive distressing memories of the event, including images, thoughts, or perceptions or
recurrent distressing dreams of the event or
acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated.)

This results in:

intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event or
physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

(iii) Persistent avoidance and/or numbing,

attempts to avoid thoughts, feelings, or conversations associated with the trauma
efforts to avoid activities, places, or people that arouse recollections of the trauma
inability to recall an important aspect of the trauma
markedly diminished interest or participation in significant activities
feeling of detachment or estrangement from others
restricted range of affect (e.g., unable to have loving feelings)
sense of a foreshortened future (e.g., does not expect see children grow up)

(iv) Persistent symptoms of increased arousal,

difficulty falling or staying asleep
irritability or outbursts of anger
difficulty concentrating
hypervigilance
exaggerated startle response