PTSD Symptom Clusters

Trauma is subjective, yet nearly every person in the world experiences it in some form or another. Many people can move forward from their traumatic experiences but for some, trauma can lead to further mental health struggles that may require outside help.

The ripple effects trauma creates in our lives is our own unique journey. While the impacts of trauma are unique to each person, psychologists have discovered sets  related effects across the board called “symptom clusters.” 

What is PTSD?

Posttraumatic stress disorder (PTSD) is a mental health disorder that develops in some people after they have experienced a traumatic event. Doctors generally diagnose PTSD after symptoms related to the trauma persist for at least one month, and when someone presents two or more symptoms within a cluster. 

Not everyone who has experienced trauma will develop it, and some people won’t even show symptoms until months or even years after the event. Everyone has different triggers that make their PTSD symptoms rise to the surface.

How Do People Get It?

People with PTSD usually get it from experiencing or witnessing a traumatic event that puts their or someone else's life or well being in harm's way. 

Most commonly, these events are experiences relating to physical danger, such as:

• Physical or sexual assault 
• Military combat 
• Serious accidents 
• Childhood abuse 
• Natural disasters
• Serious health issues or medical emergencies

However, trauma can also come from injury to mental well being, like the death of a loved one or the end of a relationship. 

Trauma is an emotional response to a distressing event. Although, this response isn’t universal, and even two people experiencing the same traumatic event could react differently. There are factors that may put people more at risk of developing PTSD, but overall there is no telling who will be affected by it.

What Is a Symptom Cluster?

PTSD is not defined by one singular symptom, but rather a cluster of them. A symptom cluster is a group of symptoms that are related or connected in some way. In order for a group of symptoms to be considered a cluster, they must stem from the same root issue.

PTSD is a complex disease that is generally characterized by four symptom clusters that present themselves together to create the overall disorder. Someone with PTSD might show symptoms from only one cluster, or from several.

Flashbacks, Intrusive Thoughts, or Memories

Also called simply re-experiencing, this symptom cluster relates to all the intrusive thought symptoms of PTSD. After experiencing or observing traumatic events, people often have unwanted intrusive memories about that event. These intrusions linger much longer than they do in people without PTSD. 

Intrusion Cluster Symptoms

• Flashbacks 
• Thoughts or memories 
• Dreams and nightmares 

Flashbacks can make someone feel as though they are reliving it in the present time. They can sometimes be so vivid that they create sensory and physical sensations. 

Avoidance

In order to protect themselves from these intrusive thoughts, someone with PTSD may work to avoid any reminder, memory, or thoughts of the trauma. These could be conscious or unconscious efforts.

Avoidance Symptoms

• Attempting to avoid any thoughts or conversations about the traumatic event
• Intentionally avoiding places, people, activities, or other reminders of the traumatic event
• Becoming emotionally detached and avoiding people or activities that used to bring joy 

In some cases, our brains try to protect us from the trauma by making us forget about it altogether, or parts of it.

Negative Thought Patterns and Mood

A trauma experience that leads to PTSD can change a person’s whole mood and thought process to a more negative outlook.

Negative Thought Pattern Symptoms

• Persistent negative outlooks and beliefs about themselves and the world 
• Feelings of guilt, anger, fear, or shame
• Feeling alone and estranged from everyone
• Memory problems, difficulty focusing, and indecisiveness

An unfortunate truth is that many people who have experienced trauma blame themselves for it. Many counselors and loved ones have heard statements like, “The world is dangerous. People are bad. It’s my fault it happened.” 

Processing and moving past this trauma can lead to a more optimistic outlook. The counselors at Sequoia Behavioral Health specialized in trauma therapies like emotional freedom techniques and forward-facing therapy to help our clients feel safe and grounded.

Changes in Physical and Emotional Reactions

Trauma and PTSD can cause people to change how they respond emotionally and physically to their own thoughts and emotions and their environment.

Physical and Emotional Reaction Symptoms 

• Reckless and destructive behavior like driving fast or substance abuse
• Angry outbursts, aggressive behavior, and irritability 
• Being on-edge or hypervigilant all the time
• Changes in sleep patterns, insomnia, or other sleep issues

Our thoughts, emotions, and behaviors are interconnected. When our mental health is stressed, we’re also likely to see it manifest physically and behaviorally.  

The Different Models of Symptom Clusters

The standard of diagnosing mental health, behavioral, and personality disorders is the Diagnostic and Statistical Manual of Mental Health Disorders, or the DSM. This manual is on its fifth edition, called the DSM-5.

The four clusters listed above are outlined in the DSM-5, but they aren’t the only models psychologists have discussed. The DSM-IV only noted the intrusive thought, avoidance, and physical and emotional clusters.

However, some still think that a seven-factor model is the best way to classify PTSD symptom clusters. They are:

• Re-experiencing
• Avoidance
• Negative affect
• Anhedonia (inability to feel pleasure)
• Externalizing behaviors
• Anxious arousal symptoms (hypervigilance)
• Dysphoric arousal symptoms (irritability, inattentiveness)

As you can see, the DSM-5 categorizes several of these seven together, and is a little less granular in separating symptoms. Despite these differing models, the diagnostic criteria for PTSD remains the same. 

Treating PTSD

PTSD is a complex issue that can disrupt every aspect of your life. It is critical to seek professional help after trauma to set yourself on a path of mental wellness. 

The compassionate and experienced team at Sequoia Behavioral Health wants to help you manage your PTSD symptoms and even resolve them altogether. 

If you or someone important to you are suffering from PTSD symptoms, reach out today! We can help you or a loved one move past surviving and onto thriving.