PTSD Vignette

¶ … vignette I have experienced a traumatic event and do have some symptoms; however, my presentation is not consistent with the diagnostic criteria in the DSM -- 5 (American Psychiatric Association [APA], 2013). Therefore, I do not have PTSD; or at least at this point I do not qualify for a formal diagnosis of PTSD. There are a couple of reasons for this: First, at this point I have experienced a traumatic event (criterion A).

Following the event I have had a nightmare, some flashbacks, and some autonomic nervous system symptoms such as increased respiration and dizziness. So there are two intrusion symptoms (flashbacks and nightmares; criterion B), and some anxiety -- related type symptoms such as heavy breathing and feeling dizzy which appear to be best satisfied by criterion E (APA, 2013). Some of the diagnostic criteria for PTSD such as criterion C (avoidance), criterion D (negative alterations of cognition) are not met or at least not addressed (APA, 2013). Second and most importantly, criterion F.

And criterion G. do not yet appear to be satisfied. For instance, there is no information on whether or not the symptoms are causing me significant distress or impairment in my functioning (criterion G; APA, 2013). However, even if I had symptoms that were covered by all of the criteria A through E, because the duration of the symptoms is only a few days and not more than a month the individual cannot be diagnosed with PTSD at this time (criterion F; APA, 2013).

Thus, no matter what my presentation is a few days after the traumatic experience I could not be formally diagnosed with PTSD. The onset and duration of the symptoms could make one believe that I might qualify for a diagnosis of acute stress disorder; however, again there are not enough symptoms described here for a formal diagnosis of acute stress disorder to be made (in order to be diagnosed with acute stress disorder there must be nine or more symptoms from any of or all of five different categories; APA, 2013).

There is a strong relationship between the onset of PTSD symptoms immediately following a traumatic experience and a later diagnosis of acute stress disorder or PTSD (APA, 2013). However, the research literature also indicates that most of the people who witness or experience a very traumatic event have similar symptoms and yet do not develop a psychiatric disorder such as PTSD (Ozer, Best, Lipsey, & Weiss, 2008).

Thus, at this point it would be pertinent for me to talk to someone regarding how I'm feeling and have a mental health professional or counselor and follow me for short period of time. The majority of cases such as this one typically resolve over time (Resick, Monson, & Rizvi, 2008). Thus, while being exposed to, learning about, or witnessing a traumatic event is necessary in order to receive a formal diagnosis of PTSD it is not sufficient.

I do have a mild sense of the subjective experience that people with PTSD go through. When I was younger I actually witnessed a very traumatic event which left an impression on me for quite some time. I was walking across the railroad tracks by my home and about 10 m from me there was a small group of younger teenage males standing in the middle of the tracks. As I crossed the tracks I noticed that there was a train heading towards us at about 100 m away.

I heard to get across the tracks but notice of the group of teenage males simply stood there. I watched in horror as the individuals faced the oncoming train, obviously playing a game that is sometimes known amongst young males as "chicken." The idea of this rather ridiculous game is to be the last person to jump off the tracks before the train comes. One of the young men waited a little too long and was hit by the train.

His body bounced along the side of the tracks and I rushed up to see if he was okay. It was a gruesome sight. His head was totally caved in, his legs were twitching, and there was blood everywhere, as I recall the story I can still vividly see the body. The police were called and we all had to fill up these reports and at one point the police thought I was involved but it became clear to them that I was not.

For the next several days I kept having intrusive flashbacks of the scene. I felt rather depressed, slow, and numb. I also had a couple of dreams from which I was awakened and was quite nervous. I am unable to recall the actual content of the dreams, in fact I was not able to recall them.