J. Gayle Beck, professor of psychology, is an expert in panic and anxiety disorders and Post Traumatic Stress Disorder.

	Gayle

What is Post Traumatic Stress Disorder (PTSD)?

PTSD is an anxiety-based disorder that may follow in the wake of a trauma. Let's define trauma, for starters. Within our current diagnostic framework, a trauma is an event involving actual or threatened loss of life or personal integrity that one directly experienced that results in an emotional response of extreme fear, helplessness, terror, etc. This definition leaves out "ordinary tragedies," such as miscarriage. By definition, PTSD refers to symptoms that have persisted for at least one month after exposure to a trauma. These symptoms include such things as intrusive thoughts and dreams about the trauma, avoidance of situations that remind one of the trauma, emotional numbing, difficulty concentrating, trouble sleeping, feelings of jumpiness, etc.

Is there a new kind of patriotism brewing in America as a result of these terrorist attacks?

I certainly hope so, though so far it is the more traditional nationalistic form that has sustained and given courage to most Americans. This is important, but if we face some profoundly new 21st century type of "war," as Secretary (of Defense Donald) Rumsfeld has said, then I sense we desperately need to imagine and construct a similarly new 21st century patriotism, one that connects us to people around the world rather than isolates us from them, that sees our mutual interdependence as the source of our horrific vulnerability—and the crucial resource for our survival.

We usually think of someone acquiring PTSD from serving in a war. Are there other kinds of trauma that can lead to this condition?

Most certainly. Rape is the most common trauma to occur in women and carries a high risk for PTSD. Motor vehicle accidents also are an extremely common trauma. In fact, here at UB I direct a unique motor-vehicle-accident clinic that caters to individuals who have been involved in serious wrecks and need help to work through the "aftermath of the trauma." Other traumas include childhood sexual abuse, being "jumped," being in a fire, flood, etc.

What's the difference between PTSD and Post Traumatic Stress (PTS)?

Clinically, PTSD is a collection of symptoms that last more than a month and are usually associated with people who have witnessed or been the victim of a traumatic event. Not enough time has passed yet for PTSD to be diagnosed in a person affected directly by the terrorist attacks on the World Trade Center and the Pentagon. PTS, on the other hand, is something we all are experiencing in the wake of the attacks. Symptoms include nightmares, intrusive thoughts and other ways in which we may "re-experience" the trauma, trouble concentrating, hyper-vigilance and feeling anxious or jumpy.

Who are the most vulnerable for developing PTS?

Those who have had previous exposure to any trauma that threatened their physical or psychological integrity are most vulnerable to post-traumatic stress. These are people who have been victims of sexual abuse, physical assault, terrible accidents or of natural disasters—earthquakes, fires, floods, hurricanes, tornadoes. They should be particularly careful at this time because there seems to be a relationship between PTS symptoms and a high total dosage of exposure to trauma.

What are some coping mechanisms that can be used to deal with PTS linked to the terrorist attacks?

If you are suffering from these symptoms, try to manage them by turning off the television. Viewers should be particularly concerned about the continuing coverage on CNN, MSNBC and Fox because it tends to repeat the most horrifying film footage over and over again, and presents vivid descriptions of victims jumping, burning, being blown apart and presumptive talk about their last moments on earth—all of which are likely to conjure terrifying and repetitive images in the minds of viewers. Another good way of processing this information and diffusing its effects is by talking to other people, repeating stories and sharing feelings, fears and information. This may be done through public services, church groups or groups of family, neighbors and friends, even with strangers. Also, I'd encourage people to follow "healthy" coping strategies, like exercise and prayer, and monitor themselves so that "unhealthy" coping strategies, like drinking and sleeping too much, don't get out of hand.

How long does PTS last? How do you know it's time to seek professional help?