Topics tagged with "Anger"


What are hyperarousal symptoms in PTSD? Hyperarousal is a core symptom of PTSD, with at least two hyperarousal symptoms being required for a diagnosis. Hyperarousal symptoms include irritability or aggression, risky or destructive behaviour, hypervigilance, heightened startle reaction, difficulty concentrating, and difficulty sleeping. What is the evidence regarding hyperarousal in people with PTSD? Moderate to high quality evidence finds small effects of less sleep efficiency, less total sleep time, less slow wave sleep, and more wake time after sleep onset in people with PTSD. Moderate to low quality evidence finds a medium-sized effect that people with PTSD and sleep disturbances…

Anger and aggression

Is anger and aggression common in PTSD? Excessive anger is often observed in people with PTSD and other anxiety-related disorders. In PTSD, a propensity towards excessive anger may be apparent before exposure to a trauma, for example as a personality trait. Or it could be a result of exposure to the trauma itself and a symptom of PTSD. Elevated anger in people with PTSD has clinical implications as it may be a barrier to effective treatment outcomes. Therefore, anger and aggression are key targets for improvement early in the treatment process. What is the evidence for anger and aggression in…

Assessment tools

Assessment tools

What are assessment tools for PTSD? Standardised assessment tools for PTSD are vital for assessing a range of variables including symptoms, functioning, and quality of life. They are often used within a controlled research environment, but high-quality assessment tools are also useful in practice for both clinical management and outcome prediction. What is the evidence for outcome assessment tools for PTSD? Moderate quality evidence finds a model comprising 4-factors of intrusions, avoidance, hyperarousal, and dysphoria/numbing yielded the best fit for clustering PTSD symptoms. Assessment measures for this model included the Clinician-Administered PTSD Scale, Harvard Trauma Questionnaire, Modified PTSD Symptom Scale,…


How is a PTSD diagnosis made? A PTSD diagnosis requires exposure to at least one trauma. Traumas include being exposed to threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Examples are direct exposure, witnessing a trauma, or learning that a relative or close friend was exposed. At least one “intrusion” symptom is required for a PTSD diagnosis. These symptoms include unwanted and upsetting memories, nightmares, flashbacks, and emotional distress or physical reactions following reminders. At least one “avoidance” symptom is also required for a PTSD diagnosis. These symptoms include avoidance of trauma-related thoughts or feelings,…

Medications for aggression and agitation

How is aggression and agitation relevant to schizophrenia? Agitation and/or aggression are sometimes observed during a psychiatric emergency such as in onset of acute psychosis. Agitation typically includes irritability and restlessness, motor or verbal hyperactivity, uncooperativeness, and occasionally aggressive gestures or behaviour. This can pose a risk both to the individual, as well as the attending health care professionals, and so is important to manage this behaviour and prevent potential harm. What is the evidence for treatments for aggression and agitation? Moderate quality evidence found a small to medium-sized effect of less hostility with second-generation antipsychotics compared to first-generation antipsychotics,…

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