Your character and traumatic experience: PTSD.

[Sixx]

During the 10th Anniversary Skype call, the subject of PTSD (Posttraumatic Stress Disorder) was mentioned and discussed, speaking of how many of the characters that were taking part in the storyline had lived through such horrific experiences that they will probably not be able to return in the same way they were.

Many have been/seen others tortured, forced to kill, fight, perhaps been abused... all under the psychological stress of war and persecution in a hostile environment. Me being a psychologist and having access to some diagnostics books, I thought I'd give you the criterion that mark PTSD, so you have a to-go on what some of your characters might experience.

I will be using the criterion of the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association's manual on psychiatric disorders, in its Vth edition. I have added aditional explanations of my own because I had to post a bit of a shorter version, since the textbook one is several pages long of no real significance to us for the sake of roleplay. If you have any questions, in any case, feel free to whisper Ashcroft in-game, and I hope I'll be able to help you.

HUGE DISCLAIMER
We are playing a game involving FANTASY. This includes fantasy violence, fantasy slavery, fantasy crime, fantastic character motivations/reactions, and the idea of choice over how we want our character to develop. I don't expect players to have their characters react to this like a human being would in the real world because it's fantasy.

This post is just a GUIDELINE of symptoms people who choose to have their characters have a strong psychological reaction to the events in their life can use, because TGT is an unforgiving setting in which patrons and slaves alike live through/have lived through terrible experiences. This is OPTIONAL, and your character will not be expected to suffer in this way unless it's something you as a player wish to explore in your roleplay.

... Also, I don't have to tell you not to use this as a diagnostic tool yourselves in a real life scenario, right? That it's a resumed version meant to help you RP a character right? You'll get professional help for a friend if you think they need it instead of using a post you read in a Furcadia dream forum, right? Yes, thank you.

DSM-5 diagnostic criteria
Currently, diagnosis of PTSD is based on 8 criteria from the DSM-5.

The first DSM criterion has 4 components, as follows:

• Directly experiencing the traumatic event(s)
  Witnessing, in person, the event(s) as it occurred to others
  Learning that the traumatic event(s) occurred to a close family member or friend
  Experiencing repeated or extreme exposure to aversive details of the traumatic event(s)(Note from Sixx: "This means for example a rescue team being the first to get to the scene of a catastrophe and seeing the bodies around them, or f.e. a police officer who often sees child abuse material... people who were not part of the event but still saw the event's horrible consequence first hand); this does not apply to exposure through media such as television, movies, or pictures

Additional explanation: This criterion explains what the circumstances of the traumatic events are that usually develop the disorder. Traumatic events as described by the DSM are anything like child abuse, rape, war, torture... etc. the person has to directly have experienced them, to have read of it in a book is not enough of a stressor.

The second criterion involves the persistent reexperiencing of the event in 1 of several ways:

• Thoughts or perception
  Images
  Dreams
  Illusions or hallucinations
  Dissociative flashback episodes
  Intense psychological distress or reactivity to cues that symbolize some aspect of the event
  Unlike adults, children reexperience the event through repetitive play rather than through perception.

Additional explanation: This criterion explains how PTSD shows a fixation with the event. Your characters would probably have invasive thoughts about the events that interrupt their everyday lives, or nervous breakdowns with things reminding them of them strongly. These can be memories, or dissociative experiences (flashbacks) that take them away from their immediate reality in the way of a hallucination. 1 of these symptoms is enough, but more can be present.

The fourth criterion is 2 or more of the following symptoms of negative alterations in cognitions and mood associated with the traumatic event(s):

• Inability to remember an important aspect of the event(s)
  Persistent and exaggerated negative beliefs about oneself, others, or the world
  Persistent, distorted cognitions about the cause or consequences of the event(s)
  Persistent negative emotional state
  Markedly diminished interest or participation in significant activities
  Feelings of detachment or estrangement from others
  Persistent inability to experience positive emotions

Additional explanation: Someone suffering from PTSD will often express negative ideas about themselves, others, or the world in general ("I am a bad person", "they think I'm crazy, they fear me", "the world is a horrible place") and will often distort the memories, blaming themselves, or making the consequences of an event that was not related to them directly their fault ("I didn't do anything to stop it"). 2 of these symptoms are expected in someone to be sure we're talking about PTSD.

The fifth criterion is marked alterations in arousal and reactivity, as evidenced by 2 or more of the following:

• Irritable behavior and angry outbursts
  Reckless or self-destructive behavior
  Hypervigilance
  Exaggerated startle response
  Concentration problems
  Sleep disturbance

Additional notes: As is pretty obvious, things like insomnia, "being on their toes" or generally expressing anger, depression or an anxious everyday life is expected. Select 2 from the list at least.

The remaining 3 criteria are as follows:

• The duration of symptoms is more than 1 month
  The disturbance causes clinically significant distress or impairment in functioning
  The disturbance is not attributable to the physiological effects of a substance or other medical conditionFirst DSM diagnostic criterion