Post Traumatic Stress Disorder (PTSD) – Diagnostic Interview

OPEN QUESTIONS

• What is the most traumatic/frightening experience you have had in your life?
• How does it affect you now?

INTRUSION SYMPTOMS ASSOCIATED WITH TRAUMA

• Could you describe the event? (ask first if the person has difficulty talking about the event)
• How often do you think about it?
• Do you ever have thoughts about the event that seem to force their way into your mind? (Intrusion symptoms)
• Do you ever have nightmares about the event? (Intrusion symptoms)
• Do you ever get flashbacks? (Intrusion symptoms)
• Do you ever feel like it’s happening all over again? (Intrusion symptoms)
• Do you have difficulties remembering the accident?

AVOIDANCE

• Do you find yourself avoiding things that you associate with the memory?
• Have you been back to the place where the event took place?
• How hard is it for you to talk about the event?
• Are there any activities that you avoid?

ALTERATIONS IN COGNITIONS AND MOOD

• How has trauma affected your life?
• Has it affected the way you feel?
• Have friendships suffered?
• Are you still able to have feelings for loved ones?
• Do you ever feel numb?
• How do you see the future?
• Has the trauma affected your interest in activities?
• Do you blame yourself/ Have you been feeling guilty about the event?

ALTERATIONS IN AROUSAL AND REACTIVITY

• Since the trauma, have you felt on edge much of the time?
• Do you startle easily?
• Have you been feeling irritable?
• What is your sleep like?
• Have you had difficulty concentrating?

IMPORTANT POINTS IN CLINICAL PRACTICE

• Post Traumatic disorder is co-morbid unless proven otherwise
• Diagnostic overshadowing is a risk: Cognitive and Behavioural symptoms can be attributed to trauma as opposed to the onset of a Major Depressive Disorder or Mood Disorder
• Depression can easily be missed in PTSD
• Substance use is highly associated
• There is a high risk of suicide

Read the neuropsychiatry and treatment of PTSD.