Post-Traumatic Stress Disorder

Abstract

Abstract This chapter describes how post-traumatic stress disorder (PTSD) is diagnosed, contrasting traditional “broad” formulations with a “narrow” formulation focusing on core symptoms introduced in ICD-11. The ICD-11 distinction between PTSD and complex PTSD is also described. Next, the chapter presents the two signature changes consisting of vivid re-experiencing of the traumatic event in the present coupled with impaired voluntary recall of the event. Other aspects of memory affected in PTSD that are unrelated to the traumatic event are also described. Three prominent controversies are discussed: whether traumatic memories are “special,” whether traumatic events can be forgotten, and whether there is evidence for delayed-onset PTSD. Contemporary theories of PTSD are then described, all of which identify deficits in memory for context as central to the disorder. Finally, the chapter discusses likely mechanisms involved in psychological therapy for PTSD: habituation/extinction, updating/reconsolidation, and metacognitive change.