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Posttraumatic Stress Disorder (PTSD)
Posttraumatic Stress Disorder (PTSD)
Guntara Hari
Psikiater
Eka Hospital BSD
DEFINITION
An anxiety disorder emerging after exposure to
an extreme traumatic stressor involving actual
or threatened death or serious injury.
To qualify as ‘‘traumatic,’’ the stressful event
must pose a threat to life or limb.
The same life-threatening event ≠ traumatic:
Horrified : a potential candidate for a diagnosis of
PTSD.
Fearless: non potential.
Carol S.North, Sean H. Yutzy, Goodwin and Guze’s Psychiatric Diagnosis,Sixth Ed,Oxford,2010
EPIDEMIOLOGI
Penyalahguna napza
EPIDEMIOLOGI
Asma bronkhiale
Gastritis
Cephalgia
Psikosomatik lainnya
ETIOLOGI
Stresor > kapasitas mental
Faktor predisposisi:
Riwayat gangguan psikiatrik (pasien & keluarga)
Dukungan sosial
ASPEK
BIOLOGIK
GSPT
Respons takut
Pitman,1989
Potential consequenses of low cortisol during trauma
Excessive catecholamines at the time of trauma
Frequent anxiety
Pitman,1989
C. Persistent avoidance of stimuli associated with the trauma and numbing of general
responsiveness (not present before the trauma), as indicated by three (or more) of the
following:
(1) Efforts to avoid thoughts, feelings, or conversations associated with the trauma
(2) Efforts to avoid activities, places, or people that arouse recollections of the trauma
(3) Inability to recall an important aspect of the trauma
(4) Markedly diminished interest or participation in significant activities
(5) Feeling of detachment or estrangement from others
(6) Restricted range of affect (e.g., unable to have loving feelings)
(7) Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children,
or
a normal life span)
D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two
(or more) of the following:
(1) Difficulty falling or staying asleep
(2) Irritability or outbursts of anger
(3) Difficulty concentrating
(4) Hypervigilance
(5) Exaggerated startle response
GAMBARAN KLINIS: KRITERIA DIAGNOSIS DSM IV-TR
Adapted from diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition text
revision. Washington, DC: American Psychiatric Association, 2000.
PENATALAKSANAAN