Diagnosing Post-Traumatic Stress Disorder

NYU Langone specialists diagnose post-traumatic stress disorder, or PTSD. This is an anxiety disorder that develops after a person experiences or witnesses a traumatic, life-threatening event, such as a natural disaster, violent personal assault, serious accident, or war.

Shock, fear, upsetting memories, jumpiness, nightmares, or trouble sleeping are common after a traumatic event. For most people, these reactions diminish over time. But for people with PTSD, they remain intense.

A person with PTSD may feel stressed or frightened, even when he or she is no longer in danger. These feelings may become so strong that they affect the way a person lives his or her life.

NYU Langone specialists are experts at diagnosing and treating PTSD in military veterans, active duty service members, and their families.

Causes and Symptoms

PTSD is believed to affect more than five million U.S. adults in a given year, although the condition can occur at any age—even in childhood. Women are more likely to develop PTSD than men, and the condition may run in families.

Not everyone with PTSD has directly experienced a traumatic event. Some people develop the condition after a friend or family member has been exposed to danger or is harmed, or after the unexpected death of a loved one.

PTSD symptoms usually begin soon after the traumatic event—often within three months—but sometimes they may not appear until months or years later. Symptoms may come and go over the course of many years.

There are four main types of PTSD symptoms:

• Re-experiencing: A person may relive the traumatic event through distressing recollections, flashbacks, and nightmares.
• Avoidance: A person may become emotionally numb and avoid places, people, and activities that remind him or her of the trauma.
• Negative alterations in mood and cognition: A person may feel cut off from others and experience negative changes in his or her mood, beliefs, ways of thinking, or remembering.
• Hyperarousal: A person may have difficulty sleeping and concentrating, feel jumpy, and be easily irritated and angered.

In addition, people with the condition may abuse alcohol or drugs. They may also experience depression or anxiety, pain, rapid breathing or heart rate, and sweating.

Children and adolescents can also experience anxiety disorders such as PTSD, but their symptoms may be different than those of adults. In very young children, symptoms include bed-wetting, changes in language and communication, acting out the event during playtime, or being unusually clingy.

Older children and teens usually have symptoms similar to those of adults. They also may be disruptive, disrespectful, or destructive. In addition, they may feel guilty for not preventing the traumatic event, or have thoughts of revenge.

Criteria for Diagnosis

To receive a diagnosis of PTSD, a person must have at least one re-experiencing symptom, at least three avoidance symptoms, at least two negative alterations in mood and cognition, and at least two hyperarousal symptoms for a minimum of one month. These symptoms must affect the person’s ability to perform everyday activities.

Experts at NYU Langone use questionnaires and rating scales to determine if a person meets the diagnostic criteria for PTSD.

Evaluation

During an evaluation, a psychologist or psychiatrist asks about your exposure to a traumatic event and the impact your symptoms are having on your everyday life, such as attending school or work, socializing, or completing important tasks. He or she may ask about your quality of life, your relationships, signs of depression or substance abuse, and thoughts of suicide.

Our specialists sometimes speak with spouses or partners, family members, and close friends. This helps them to obtain a complete picture of a person’s quality of life and how symptoms affect his or her everyday activities.

An NYU Langone psychiatrist or psychologist may perform neuropsychological testing to assess a person’s cognitive abilities, such as attention, memory, and problem solving. A series of verbal and written tests assesses a person’s thinking, behaviors, and emotions. These tests provide detailed information about a person's cognitive strengths and weaknesses.

After an evaluation is complete, our specialists hold a feedback session with you to discuss findings and treatment recommendations. Our clinicians have a long history of working with veterans and military families, understanding their experiences, and providing the most effective treatment.