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DSM-IV
sisting symptoms for longer than 12 months after the trauma. The severity, duration, and proximity of an individual's exposure to the traumatic event are the most important factors affecting the likelihood of developing this disorder. There is some evidence that social supports, family history, childhood experiences, personality variables, and preexisting mental disorders may influence the development of Posttraumatic Stress Disorder. This disorder can develop in individuals without any predisposing conditions, particularly if the stressor is especially extreme.

Differential Diagnosis

In Posttraumatic Stress Disorder, the stressor must be of an extreme (i.e., life-threatening) nature. In contrast, in Adjustment Disorder, the stressor can be of any severity. The diagnosis of Adjustment Disorder is appropriate both for situations in which the response to an extreme stressor does not meet the criteria for Posttraumatic Stress Disorder (or another specific mental disorder) and for situations in which the symptom pattern of Posttraumatic Stress Disorder occurs in response to a stressor that is not extreme (e.g., spouse leaving, being fired).

Not all psychopathology that occurs in individuals exposed to an extreme stressor should necessarily be attributed to Posttraumatic Stress Disorder. Symptoms of avoidance, numbing, and increased arousal that are present before exposure to the stressor do not meet criteria for the diagnosis of Posttraumatic Stress Disorder and require consideration of other diagnoses (e.g., a Mood Disorder or another Anxiety Disorder). Moreover, if the symptom response pattern to the extreme stressor meets criteria for another mental disorder (e.g., Brief Psychotic Disorder, Conversion Disorder, Major Depressive Disorder), these diagnoses should be given instead of, or in addition to, Posttraumatic Stress Disorder.

Glossary













How the doctor uses this information to make a diagnosis.

Again, sometime misunderstood by clinicians. If someone was killed, or nearly killed, it is life-threatening.








The test here is if you experience one or more of these symptoms, did you have them befor or after the trauma. If after, the chances are greater that it is PTSD.
Here, too, officer's may have to "explain" the situation to the doctor. You can be anxious, or depressed or whatever, befor the trauma. But if you experience a trauma FOLLOWED BY SERIOUS AND PERSISTENT symptoms, again, this may be diagnosed as PTSD. 		Additional commentary













Differential Diagnosis:
It is good to remember that doctors can be intimidated by police and they may not ask you for all the information that is needed to make a proper Differential Diagnosis.
Further, a doctor may think that because you're a cop, you see death and destruction all the time, and assume therefore, that you will not be affected by any particular traumatic event.
A police chief once said that the only problem with cops is the only place we have to recruit them from is the human race.
Humans have human problems and sometimes even doctors need to be reminded.


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