Post-traumatic stress disorder at the end of life.

What Is Post-traumatic Stress Disorder? Post-traumatic stress disorder (PTSD) is an anxiety disorder that can occur after a person has experienced or witnessed life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults such as rape (National Center for Post-Traumatic Stress Disorder Web Site, 2006). It has been demonstrated that witnessing death or serious injury to others is sufficiently stressful to cause PTSD (Carson et al., 2000). In addition, individuals who have been in the position of harming or killing others (e.g., in a motor vehicle accident or in combat) can face significant traumatic stress after the experience. Findings show that soldiers who have killed in combat, or believe that they have, experience higher rates of PTSD (Baum, 2004). Any trauma, especially, when prolonged or repeated, may convert the ordinary adaptive response of “fight or flight” into a pathologic reaction (Allen, 1995). The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (American Psychiatric Association, 2000) defines trauma as any event that a person experiences, witnesses, or is confronted with that threatens death or serious injury or is a threat to the physical integrity of oneself or others. Most survivors of trauma, especially those with adequate coping mechanisms, can adjust to the incident and have no lingering effects. However, some persons have stress reactions that do not abate and may worsen over time. These reactions can develop into PTSD, which may be severe enough to have a significant impact on their daily life, as well as that of their spouses, family, and significant others. Tick (2005) describes PTSD in the following passage: