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'''Post-traumatic stress disorder (PTSD)''' was not recognized as a disease until 1980, when the American Psychiatric Association created a new classification of disease.<ref name="dsm1980">{{REFbook |last=American Psychiatric Association |first= |year=1980 |title=Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) |url= |pages= |isbn= |accessdate=2021-08-08 }}</ref><ref name="vanderkolk2014A">{{REFbook |last=van der Kolk |first=Bessel |init=BA |author-link=Bessel van der Kolk |year=2014 |title=The Body Keeps the Score |url= |page=19 |isbn=978-0-14-312774-1 |accessdate=2021-08-07 }}</ref> Prior to that time, the condition was variously called ''shell [[shock]]'' or ''combat fatigue''. The following text is quoted from the [{{WikipediaQuote|URL=https://en.wikipedia.org/wwiki/index.php?Post-traumatic_stress_disorder|title=Posttraumatic_stress_disorder Wikipedia]:Post-traumatic stress disorder}}
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'''Posttraumatic Post-traumatic stress disorder''' ('''PTSD''') may develop after a person is exposed to one or more traumatic events, such as major stress, sexual assault, terrorism, or other threats on a person's life.<ref>American Psychiatric Association (2013). ''Diagnostic and Statistical Manual of Mental Disorders '' (5th ed.). Arlington, VA: American Psychiatric Publishing. pp. 271–280. ISBN 978-0-89042-555-8.</ref> The diagnosis may be given when a group of symptoms, such as disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal, continue for more than a month after the occurrence of a traumatic event.
Most people having experienced a traumatizing event will not develop PTSD.<ref>National Collaborating Centre for Mental Health (UK) (2005). [https://www.ncbi.nlm.nih.gov/books/NBK56494/ "Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care"]. NICE Clinical Guidelines, No. 26. Gaskell (Royal College of Psychiatrists). [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0015848/ Lay summary] – Pubmed Health (plain English).</ref> People who experience assault-based trauma are more likely to develop PTSD, as opposed to people who experience non-assault based trauma such as witnessing trauma, accidents, and fire events.<ref>Zoladz, Phillip (June 2013). "Current status on behavioral and biological markers of PTSD: A search for clarity in a conflicting literature". Neuroscience and Biobehavioral Reviews 37 (5): 860-895. https://dx.doi.org/10.1016%2Fj.neubiorev.2013.03.024</ref> Children are less likely to experience PTSD after trauma than adults, especially if they are under ten years of age. War veterans are commonly at risk for PTSD.
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==References=Child circumcision as a traumatizing event===When an infant boy is to be [[circumcised]], it is the usual practice to immobilize the infant for the [[Pain| painful]] surgery by securely tying his limbs to a molded plastic board specially made for that purpose called a [[circumstraint]]. The infant thus is preventing from fighting or fleeing, which is the [[trauma]]-producing situation of ''inescapable [[shock]]'', described as a "''physical condition in which the organism cannot do anything to affect the inevitable''."<ref name="vanderkolk2014B">{{REFbook |last=van der Kolk |first=Bessel |init=BA |author-link=Bessel van der Kolk |year=2014 |title=The Body Keeps the Score |url= |page=76 |isbn=978-0-14-312774-1 |accessdate=2021-08-12 }}</ref> The male [[circumcision]] operation to amputate the [[foreskin]] has been shown to be a traumatic event. Taddio & colleagues (1995)(1997) studied the effect of neonatal circumcision on the behavior of boys after surgery and at the time of vaccination. It was found that [[circumcised]] boys had a higher pain response at time of vaccination six months later as compared with [[intact]] boys,<ref name="taddio"1995">{{TaddioA etal 1995}}</ref> <ref name="taddio1997">{{TaddioA KatzJ IlersichAL KorenG 1997}}</ref> showing that the nervous system had been permanently sensitized to heightened pain sensation. Taddio et al. (1997) concluded:<blockquote>Although postsurgical central sensitisation (allodynia and hyperalgesia) can extend to sites of the body distal from the wound, suggesting a supraspinal effect, the long-term consequences of surgery done without anaesthesia are likely to include post-traumatic stress as well as [[pain]]. It is, therefore, possible that the greater vaccination response in the infants circumcised without anaesthesia may represent an <u>infant analogue of a post-traumatic stress disorder</u> triggered by a traumatic and painful event and re-experienced under similar circumstances of pain during vaccination.<ref name="taddio1997" /></blockquote> John Rhinehart, M. D., (1999) a clinical psychiatrist, reported finding numerous cases of [[PTSD]] in his adult male patients pursuant to infant circumcision.<ref>{{REFjournal |last=Rhinehart |first=John |init=J |author-link= |title=Neonatal circumcision reconsidered |journal=Tranactional Analysis Journal |date=1999-07 |volume=29 |issue=3 |pages=215-21 |url=http://www.cirp.org/library/psych/rhinehart1/ |accessdate=2020-11-28}}</ref> Boyle & Ramos (2019) studied boys in the Philippine Islands who had undergone medical circumcision and others who had suffered the traditional "''tuli''" circumcision. Of the boys who had a medical circumcision, 51 percent exhibited symptoms of [[PTSD]]. Of the boys who had a ''[[tuli]]'' circumcision, 69 percent exhibited symptoms of PTSD.<ref>{{REFjournal |last=Boyle |first=Gregory J. |init=GJ |author-link=Gregory J. Boyle |last2=Ramos |first2=Samuel |init2=S |author2-link= |etal=no |title=Post-traumatic stress disorder (PTSD) among Filipino boys subjected to non-therapeutic ritual or medical surgical procedures: A retrospective cohort study |trans-title= |language=English |journal=Annals of Medicine and Surgery |location= |date=2019 |volume=42 |issue= |pages=19-22 |url=https://www.sciencedirect.com/science/article/pii/S2049080119300305 |archived= |quote= |pubmedID=31080593 |pubmedCID=6506608 |DOI=10.1016/j.amsu.2019.04.004 |accessdate=2020-11-28}}</ref> ==Symptoms and signs of PTSD== ===Re-experiencing Symptoms===Re-experiencing is the most typical symptom of PTSD & C-PTSD. This is when a person involuntarily and vividly relives the traumatic event. * Flashbacks—reliving the traumatic event, and feeling like it happening right now including physical symptoms such as a racing heart or sweating.* Reoccurring memories or nightmares related to the event.* Distressing and intrusive thoughts or images.* Physical sensations like sweating, trembling, pain or feeling sick. Thoughts and feelings can trigger these symptoms, as well as words, objects, or situations that are reminders of the event.===Alertness and Reactivity Symptoms===You may be ‘jittery’, or always alert and on the lookout for danger. You might suddenly become angry or irritable. * Being jumpy and easily startled.* Feeling tense, on guard, or “on edge” – this is called hypervigilance.* Having difficulty concentrating on even simple and everyday tasks.* Having difficulty falling asleep or staying asleep.* Feeling irritable and having angry or aggressive outbursts.* Self-destructive or reckless behaviour.* Aversion or difficulty in tolerating sound. ===Avoidance Symptoms===Trying to avoid being reminded of the traumatic event is another key symptom of PTSD & C-PTSD: avoiding certain people or places that remind you of the trauma, or avoiding talking to anyone about your experience. * Staying away from places, events, or objects that are reminders of the experience.* Feeling that you need to keep yourself busy all the time.* Using alcohol or drugs to avoid memories.* Feeling emotionally numb or cut off from your feelings.* Feeling numb or detached from your body.* Being unable to remember details of the trauma. Avoidance symptoms may cause people to change their routines. ===Feeling and mood symptoms===The way you think about yourself and others may change because of the trauma. * Trouble remembering key features of the traumatic event.* Feeling like you can’t trust anyone.* Distorted thoughts about the trauma that cause feelings of blame and guilt.* Overwhelming negative emotions, such as fear, sadness, anger, guilt, or shame.* Loss of interest in previous activities.* Feeling like nowhere is safe.* Difficulty feeling positive emotions, such as happiness or satisfaction.<references ref>{{REFweb |url=https://www.ptsduk.org/what-is-ptsd/symptoms-of-ptsd/ |archived= |title=PTSD-UK |trans-title= |language= |last= |first= |author-link= |publisher= |website=https://www.ptsduk.org |date=2021 |accessdate=2021-08-12 |format= |quote=When we feel stressed emotionally, our bodies release hormones called cortisol and adrenaline. This is the body’s automatic way of preparing to respond to a threat, sometimes called the ‘fight, flight or freeze‘ response.}}</ref> {{SEEALSO}}* [[Adverse Childhood Experiences (ACEs)]]* [[Circumstraint]]* [[Pain]]* [[Psychological issues of male circumcision]]* [[Psychiatrist Discusses the Lasting Trauma of Circumcision]]* [[Trauma]]* [[Tuli]] {{LINKS}}* {{REFweb |url=https://www.betterhealth.vic.gov.au/health/HealthyLiving/trauma-and-children-newborns-to-two-years |archived= |title=Trauma and children - newborns to two years |trans-title= |language= |last= |first= |author-link= |publisher=Victoria Department of Health |website=Better Health Channel |date=2020 |accessdate=2021-08-14 |format= |quote=}}* {{REFweb |url=https://www.friendshipcircle.org/blog/2013/07/12/post-traumatic-stress-disorder-in-babies-and-toddlers-what-are-the-symptoms/ |archived= |title=Post Traumatic Stress Disorder in Babies and Toddlers: What Are the Symptoms? |trans-title= |language= |last=Philo |first=Jolene |author-link= |publisher=Special Needs Resources |website= |date=2013-07-12 |accessdate=2021-08-14 |format= |quote=It’s normal for children to exhibit some of these behaviors in the first weeks after a significant trauma occurs. But if the behaviors persist more than 3 months after the initial event, treatment may be needed.}} {{REF}}
[[Category:AcronymCircumcision risk]][[Category:Pain]][[Category:Psychology]][[Category:Trauma]]
[[de:Posttraumatische Belastungsstörung]]