Euphoria as a Peri-traumatic Emotion in PTSD - How Positively Perceived Emotions Can Affect the Maintenance of the Disorder: a Case Report.

Post Traumatic Stress Disorder (PTSD) is a psychiatric disorder that can occur after witnessing or experiencing life-threatening or otherwise deeply disturbing events, such as serious injuries or sexual violence. For a long time, PTSD has been classified as an anxiety disorder; other feelings such as guilt have not been in focus. In the DSM-V (American Psychiatric Association 2013), the placement of PTSD has been shifted from within the category of anxiety disorders to a new category of traumatic and stressor-related disorders (Zoellner et al. 2013). New symptoms regarding alterations in cognitions such as persistent negative beliefs and expectations about oneself or the world and persistent distorted blame of self or others for causing the traumatic event or for resulting consequences have been added to the criteria. With regard to persisting trauma-related emotions, we can separate them into two categories: peri-traumatic and post-traumatic reactions (Boos 2005). Peri-traumatic are the emotions that occur during the event and are constantly reexperienced after the event, such as fear. Emotions that occur only after the event, due to the changes in the belief-system of the patient, for example feeling guilty when he thinks of himself as responsible for the course of events are called post-traumatic. In the following case-report, we describe for the first time the phenomenon that not only negatively but also positively regarded peri-traumatic emotions can occur, and how they can contribute to the maintenance of posttraumatic symptoms.