IJSP Number 1, 2019

55 A close attention is paid to behavioral symptoms, which are divided in DSM V [7] in four groups, as opposed to three groups in DSM-IV-TR [8] • Trauma recollection : intrusive and involuntary thoughts and memories; repeating and quasi-real nightmares with content related to the traumatic experience; flashbacks; intense psychological discomfort when exposed to stimuli that remind of the trauma. • Persistent avoidance of trauma related stimuli: efforts to avoid memories, thoughts, feelings and external factors like places, people, objects, situations that can remind of the psycho-traumatic event. • Memory, thoughts and mood disorders : loss of memory regarding certain moments from the traumatic event; thoughts with negative connotations about oneself or the others; failure to see the future in an optimistic manner; self-accusation or accusation of others; negative emotions: fear, horror, anger, shame, excessive guilt; low interest for activities that were pleasant before the traumatic event; detachment, indifference; decrease in the capacity to feel positive emotions. • Increased psychological tension and activation of the vegetative nervous system (“hyperarousal”) : excitability, fits of anger, violent outbursts; self-destructive behavior; hyper-vigilance; twitching; concentration disorder; difficulty sleeping, disturbed or restless sleep. In the first month after a life-threatening psycho-traumatic experience, serious injury or the loss of a closed one an acute stress reaction can occur (ASR). Some of the acute post-traumatic symptoms are: relieving of the experience, flashbacks, nightmares, dissociative symptoms (amnesia, de-realization, and depersonalization), avoidance of trauma-related factors and increased neuro- vegetative activity. The duration of ASR symptoms is between three days and four weeks [9]. If the duration of the symptoms exceeds four weeks we can start to take in consideration PTSD. Unfortunately, a large proportion of patients that exhibit ASR symptoms develop afterwards PTSD. About 50% of the people with PTSD had ASR before. Usually PTSD occurs three months after the traumatic event. There are some forms with late onset, which occur six months after the event. PTSD can be diagnosed at any age, including in children who are greater than one [9]. According to Stiuriuc [10], the evolution of PTSD can be classified in: acute (symptoms last fewer than three months), chronic (symptoms last longer than three months), late (it manifests after six months of the traumatic event) and intermittent. 50% of patients with PTSD are completely restored in an interval of maximum three months. The rest can have persistent symptoms more than twelve months or can develop a chronic or recurrent form of the disorder.