Psychologists and psychiatrists at Shier Private Practice in Scottsdale, AZ specialize in the treatment of post traumatic stress disorder (PTSD). Our private outpatient clinic offers a comprehensive psychiatric/medical assessment and treatment plan. Treatment may include medications, behavioral therapies or a combination of treatments.

Post Traumatic Stress Disorder (PTSD) is a trauma/stress related disorder that may develop following a witnessed traumatic event such as exposure to actual or threatened death, serious injury, or sexual violence. The affected individual may subsequently develop chronic symptoms that may include nightmares, flashbacks, and uncontrollable thoughts.

The DSM-5 Criteria defines PTSD as:

A. Exposure to actual or threatened death, serious injury, or sexual violence in one (more more) of the following ways:

1. Directly experiencing the traumatic event .
2. Witnessing, in person, the event as it occurred to others.
3. Learning that the traumatic event occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event.

B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event, beginning after the traumatic event occurred:

1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event.
2. Recurrent distressing dreams in which the content an/or affect of the dream are related to the traumatic event.
3. Dissociative reactions (e.g. flashbacks) in which the individual feels or acts as if the traumatic event were recurring.
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
5. Marked physiologic reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the traumatic event, beginning after the traumatic event occurred, as evidenced by one or both of the following:

1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event.
2. Avoidance of or efforts to avoid external reminders that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event.

D. Negative alterations in cognitions and mood associated with the traumatic event, beginning or worsening after the traumatic even occurred, as evidenced by two (or more) of the following:

1. Inability to remember an important aspect of the traumatic event.
2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world.
3. Persistent distorted cognitions about the cause or consequences of the traumatic event that lead to the individual to blame himself/herself or others.
4. Persistent negative emotional state (e.g. fear, horror, anger, guilt, or shame).
5. Markedly diminished interest or participation in significant activities.
6. Feelings of detachment or estrangement from others.
7. Persistent inability to experience positive emotions.

E. Marked alterations in arousal and reactivity associated with traumatic events, beginning or worsening after the traumatic event occurred, as evidenced by two (or more) of the following:

1. Irritable behavior and angry outburts (with little or no provocations) typically expressed as verbal or physical aggression toward people or objects.
2. Reckless or self-destructive behavior.
3. Hypervigilance.
4. Exaggerated startle response.
5. Problems with concentration.
6. Sleep disturbance

The duration of symptoms B, C, D, E are present for greater than 1 month.

In the United States, the projected lifetime risk for PTSD is 8.7%. Not all individuals who experience a traumatic event develop symptoms of PTSD.  The risk of onset and severity of PTSD is complex and may involve a variety of factors including the individual’s lifetime experiences, genetics, inherited mental health risks, temperament/personality, and response to stress.

Treatment of PTSD involves medications and/or behavioral therapies.

First-line medications used in the treatment of PTSD include Serotonin Reuptake Inhibitors (SSRIS) and Serotonin Noradrenergic Reuptake Inhibitors (SNRIs).

Psychotherapies include Cognitive Behavioral Therapy (CBT) or Cognitive Processing Therapy (CPT).