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Posttraumatic Stress Disorder: From Phenomenology to Clinical Practice

Correspondence: Address correspondence to David M. Benedek, M.D.,Professor, Department of Psychiatry and Associate Director, Center for the Study of Traumatic Stress, Uniformed Services University, Bethesda, MD, e-mail: dbenedek{at}usuhs.mil.

The psychological and behavioral consequences of exposure to traumatic events—particularly combat—have been recognized throughout the ages. Since its 1982 introduction in the Diagnostic and Statistical Manual of Mental Disorders, 3^rd edition much has been learned about the pathophysiology of PTSD. Current theories focus on brain regions and neurobiological systems regulating stress and fear response, fear memory formation and retrieval. Effective pharmacologic and psychotherapeutic interventions target these systems. New treatments must prove more effective in specific subpopulations of patients with PTSD. These will include combinations of pharmacologic agents and psychotherapy, and treatments targeting different regions, receptors, or mechanisms involved in the traumatic stress response.

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