Overview of PTSD
Carol S. North, MD, MPE, DFAPA, University of Texas Southwestern Medical Center
Posttraumatic stress disorder (PTSD) is a conditional diagnosis because trauma exposure is required. Dr. North described the DSM-5 criteria for PTSD and pointed out that distress does not necessarily mean a patient has PTSD. Avoidance and numbing symptoms are indicators of PTSD; intrusion and hyperarousal symptoms are common among those who have experienced a trauma, but are not a strong indicator of illness in the absence of avoidance/numbing symptoms. Comorbid MDD or substance use is associated with PTSD but not with trauma exposure, therefore PTSD, not trauma, might be a causal risk for other disorders. Substance use disorders often are present before the trauma exposure, meaning that individuals might use PTSD as a way to rationalize their substance use.
