Post-traumatic stress disorder can develop after a person lives through or witnesses a frightening event such as combat, assault, an accident or a disaster. Symptoms last more than a month and disrupt daily life, and a trauma-informed approach helps patients feel safe during care.
Key symptoms
- Intrusive memories, flashbacks and nightmares
- Avoiding reminders, places or talk about the event
- Negative mood, guilt, shame or feeling detached
- Hypervigilance, startling easily, irritability and poor sleep
What you find on exam
- Mental status exam: mood, affect and thought content
- Ask directly about suicidal thoughts and safety
- Screen for depression, substance use and chronic pain
- Signs of hyperarousal: tense, scanning the room, quick startle
Tests
- Screening with the PC-PTSD-5, then a clinical interview using DSM-5 criteria
- PCL-5 checklist to measure and track severity
- Thyroid tests or a drug screen if a medical cause is suspected
Treatment basics
- Trauma-focused therapy: cognitive processing therapy or prolonged exposure
- Eye movement desensitization and reprocessing (EMDR)
- SSRIs such as sertraline or paroxetine, or venlafaxine
- Prazosin for nightmares in selected patients; avoid benzodiazepines
- Trauma-informed care, sleep hygiene and peer support
Red flags
- Suicidal thoughts or a plan
- Threats of violence toward others
- Heavy alcohol or drug use to cope
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Related guides
Sources: NCCPA PANCE Content Blueprint; NCSBN 2026 NCLEX-RN Test Plan; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.