Post-Traumatic
Stress Disorder
A psychiatric disorder that develops after exposure to traumatic events involving actual or threatened death, serious injury, or sexual violence. Characterized by intrusive memories, avoidance, negative mood changes, and hyperarousal.
Critères diagnostiques du DSM-5-TR
Criterion A: Trauma Exposure
Exposure to actual or threatened death, serious injury, or sexual violence.
Criterion B: Intrusion
1+ required:
- • Recurrent distressing memories
- • Traumatic nightmares
- • Dissociative reactions (flashbacks)
- • Psychological distress to cues
- • Physiological reactions to cues
Criterion C: Avoidance
1+ required:
- • Avoidance of trauma-related thoughts/feelings
- • Avoidance of external reminders
Criterion D: Negative Mood/Cognitions
2+ required:
- • Inability to recall key trauma features
- • Negative beliefs about self/world
- • Persistent negative emotional state
- • Diminished interest in activities
- • Detachment from others
- • Inability to experience positive emotions
Criterion E: Hyperarousal
2+ required:
- • Irritable/aggressive behavior
- • Reckless/self-destructive behavior
- • Hypervigilance
- • Exaggerated startle response
- • Concentration problems
- • Sleep disturbance
Additional Requirements
Timing and functional impact
- • Symptoms persist >1 month
- • Functional impairment or significant distress
- • Not attributable to substance use or medical condition
Protocoles d'évaluation
Outils validés pour le dépistage et le suivi de la sévérité
PCL-5
PTSD Checklist for DSM-5-TR
Criterion-standard 20-item self-report measure corresponding directly to DSM-5-TR symptom criteria.
Cutoff ≥33 suggests probable PTSD; symptom cluster scores guide treatment planning
CAPS-5
Clinician-Administered PTSD Scale
Structured clinical interview providing categorical diagnosis and dimensional symptom severity.
Severity ratings 0-4 per symptom; diagnoses PTSD and identifies dissociative subtype
PC-PTSD-5
Primary Care PTSD Screen
Brief 5-item screener for use in primary care and emergency settings.
3+ 'yes' responses suggests need for full PTSD assessment
DES
Dissociative Experiences Scale
Assesses dissociative symptoms often present with PTSD (derealization, depersonalization).
Mean score ≥30 suggests clinically significant dissociation
Causes et étiologie
Traumatic Events
- Combat exposure
- Sexual assault and intimate partner violence
- Serious accidents
- Natural disasters
- Childhood abuse
- Witnessing violence or death
Neurobiological
- Amygdala hyperactivity
- Prefrontal cortex hypoactivity
- Hippocampal volume reduction
- HPA axis dysregulation
- Norepinephrine and serotonin dysregulation
Risk Factors
- Prior trauma exposure (cumulative effect)
- Lack of social support post-trauma
- Peritraumatic dissociation
- Pre-existing anxiety or depression
- Female sex (2x higher prevalence)
- Genetic vulnerability (30-40% heritability)
Psychological Mechanisms
- Fear conditioning to trauma cues
- Impaired fear extinction
- Negative appraisals of trauma/self
- Experiential avoidance
- Memory fragmentation and intrusions
Sources scientifiques
PCL-5 Validation
Weathers FW, Litz BT, et al. The PTSD Checklist for DSM-5-TR (PCL-5). National Center for PTSD. 2013.
DSM-5-TR Criteria
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). 2022.
Prolonged Exposure Efficacy
Powers MB, Halpern JM, et al. A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clin Psychol Rev. 2010;30(6):635-641.
Neurobiology of PTSD
Pitman RK, Rasmusson AM, et al. Biological studies of post-traumatic stress disorder. Nat Rev Neurosci. 2012;13(11):769-787.
EMDR Meta-Analysis
Bisson JI, Roberts NP, et al. Psychological therapies for chronic post-traumatic stress disorder in adults. Cochrane Database Syst Rev. 2013;(12):CD003388.
Comorbidity Epidemiology
Kessler RC, Sonnega A, et al. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995;52(12):1048-1060.
Recherche et actualités sur PTSD Clinical Guide: PCL-5, CAPS-5 and Trauma-Focused CBT
Nouvelles, recherches et politiques récentes provenant de sources fiables.