ABSTRACT
Post-traumatic stress disorder (PTSD), as defined in DSM IV-TR, is the most common psychiatric problem associated with the stress experienced by soldiers in combat. Diagnosis of PTSD requires exposure to a traumatic event that involves experiencing, witnessing, or being confronted by death or serious injury to self or others; a response of intense fear, helplessness, or horror; and the development of a set of symptoms that persists for at least a month and cause significant impairment of functioning (APA [American Psychiatric Association], 2000). Studies have demonstrated four basic PTSD symptoms: re-experiencing (e.g., nightmares, flashbacks), avoidance (e.g., efforts to avoid thinking about the trauma), numbing of general responsiveness (e.g., restricted range of affect), and hyperarousal (e.g., exaggerated startle response) (Forbes, Creamer, Bisson, Cohen, et al, 2010; McWilliams, Cox, & Asmundson, 2005). Most individuals who develop chronic PTSD experience immediate distress that then persists over time (Buckley, Blanchard, & Hickling, 1996). However, a small but significant number of individuals report increases in PTSD symptoms over time defined as delayed onset PTSD (Palm, Strong & MacPherson, 2009; Tanielian & Jaycox, 2008).
