Acute Mental Disorders - Research Paper Example

?Running Head: Post-Traumatic Stress Disorder Post-Traumatic Stress Disorder s [Date] Table of Content Chapter 1: Introduction……………………………………………………………...4 Symptoms……………………………………………………………………………...5 Background of the problem.…………………………………………………………....6 Proper diagnosis of the disorder……………………………………………………….6 Chapter 2: Literature Review………………………………………………………..7 Factors affecting vulnerability……………….…………………………………………8 Chapter 3: Management of the disorder…………………………………………….10 Drug therapy…………………………………………………………………………...10 Cognitive Behavioral therapy………………………………………………………….11 Support groups and Family therapies…………………………………………………..11 Conclusion……………………………………………………………………………..12 Abstract Post-traumatic stress disorder is an acute mental disorder that falls under the category of anxiety disorders according to the DSM-IV TR (Diagnostic Statistical Manual of Mental Disorders). The substance of this prose assesses the symptoms, background and the intensity of the problem in soldiers and Veterans. This qualitative analysis of the disorder not only defines the perceptions of the disorder but also discusses how the sufferer cope with the symptoms and how the symptoms and behavior exhibited by the sufferer may be transmitted in their children, that significantly hampers the child’s functioning. The root of the problem lies vastly in the shattered core beliefs due to the devastation witnessed on the battlefield according to the theory proposed by Janoff Bulman. The effects of the disorder are pervasive and affect the family members and social functioning of the individual. Chapter 1: Introduction Post-Traumatic Stress Disorder or PTSD is classified as an “Anxiety Disorder” in the DSM-IV TR and is characterized by acute anxiety due to exposure to a psychologically traumatic incident. The disorder can be triggered in any individual and the most common incidents that can give rise to this problem are rapes, domestic violence or violent death of a loved one; in other words any incident that threatens the psychological or physical integrity of the individual. There are millions of factors that contribute to exacerbating the symptoms experienced by the sufferer; however, there is a significant amount difference between the vulnerability of each individual and factors such as self-efficacy, self-esteem, personality and the social support that an individual has that plays an important role in how the symptoms are exhibited by the individual. Eminent researchers Davidson and Mellor (2001) noted that children of PTSD victims were likely to exhibit the behavior exhibited b y the client and the impact is extremely pervasive They stated, “Symptoms in their children, including lower self-esteem, higher disorder rates and symptoms resembling those of the traumatized parent” (Hunter, 2001, p. 345). Therefore, it can be argued that there is a genetic diathesis involved that regulates the vulnerability of the individual effectively and also shows that the symptoms can have detrimental repercussions on the people around them. Researchers have also discovered that these effects are more pronounced on people who have witnessed combat that is soldiers and veterans. Military services have offered therapies and various programs to help and screen individual to check the impact of the violence that the client experienced on the battlefield. There is a repertoire of symptom that the individual experiences after serving in the army and this is vastly due to the hyper-vigilante state that the individual undertakes to help him perform all the tasks during combat. The violence severely affects and threatens the individual’s sense of security and as mentioned earlier shatter his or her core beliefs. The symptoms of the disorder will be discussed in greater in the following section. Symptoms An individual suffering from PTSD is haunted by the memories of the disorder and in case of soldiers, after the cessation of their service in the military they get recurrent nightmares, vivid flash-backs and thoughts of the battlefield. They relive the traumatic over and over again, they become avoidant of the stimulus, events and people associated with incident. The individual is unable to recall significant aspects of the event and cause emotional numbing in the individual. Individuals experience immense and disproportionate amount of guilt, which the psychologists have labeled as ‘survival guilt’. (Friedman et.al, 2010, p. 60) The client often is perturbed by the question that ‘how can he survive when others did not?’ and blames himself for being unable to save his comrades. The client may then resolve to self-destructive behavior in order to punish himself and may even contemplate suicide. Due to their hyper-vigilante state they are easily startled by a slight sound and often are surrounded by strong sense of alienation that renders them incapable of performing normally in social situations. They may have sudden angry outbursts and may displace their anger on their wives or children; they can be extremely violent, however, they are aware that their behavior is not normal and may question their sanity. (Friedman et.al, 2010, p. 60) Even though the individual’s insight is intact but their outbursts occur with a frightening intensity. Depression is co-morbid with PTSD symptoms and the individual is filled a sense of mortality and experience immense anhedonia; that is inability to partake in activities that were previously found pleasurable. They may resort to substance abuse and during depression, the use of narcotics becomes exaggerated and the individual’s self-esteem plummets. The etiology of the depression largely lies in the fact that they feel that no one can understand their plight and feel extremely isolated as a result. Background of the problem Conflicts and wars are one of the most integral and oldest aspects of the society. People’s experience during combat is something that is beyond normal human experiences and is highly debilitating for an individual. Years ago, wars were strictly restricted to the battlefield but nowadays entire cities rampaged and many innocent are killed during the combat. Every great nation has had their own history regarding wars and devastation, as for the United States the 10,000 day war with Vietnam and recent operation in Afghanistan and Iraq has had some major impacts on the soldiers who served in the armies. Many Vietnam veterans and soldiers who were stationed in Iraq and Afghanistan have had several problems in getting back to their normal lives and experience ample amount social and occupational dysfunctions that hamper the mental stability of people around them; especially wives and children. Furthermore the disorder is largely found in more males than females because even in combat men are at the forefront of all activities than females that severely hampers their functioning. (Friedman et.al, 2010, p. 60) Proper diagnosis of the disorder Before making a diagnosis that an individual suffers from personality disorder or schizophrenia, whereby the individual loses touch with reality and may make up stories and experience full-blown hallucinations. The clinician must also ensure that the individual’s behavior is not the result of a pre-existing mental or physical condition. After making the necessary diagnosis, only then the treatment regimen should be started. Chapter 2: Literature Review There has been immense amount of research to analyze the intensity of the problem found in people suffering from the disorder. Researchers have discovered that people suffering from disorder experience the symptoms even after several years. The most common symptoms of the disorder that are exhibited by the sufferer include acute anxiety, depression, stress and substance abuse. In 1983, a mandate issued by the congress to do an in-depth analysis of the individuals suffering from PTSD as a result of the Vietnam War. The purpose of the study was to discover exactly how many people were affected as a result of the war and contrary to the studies conducted earlier; it was found that only 26% of the war veterans showed symptoms of PTSD. According to Price (2006), individuals suffering from the disorder reported experiencing the symptoms, even though they had been taking up counseling for over twenty years. Wars veterans were likely to transfer their symptoms on to their children. (Walck, 2008, p. 19) The findings of the research conducted under the Congressional mandate was further supported by the study conducted by Rheingold, Acierno, and Resnick in 2006, which stated that individuals suffering from the disorders not only possessed a higher propensity to suffer from a health problem and often reported problems related to substance abuse. These researchers supported the argument that they found that sufferers of PTSD were likely to transfer these fears and emotional turbulence on to their children. This is vastly because children tend to emulate their behavior and there is a strong genetic diathesis involved in the process as well. However, the aforementioned finding of the study does not mean that the child will definitely experience these problems. Price has pointed out that these findings only indicate that these aspects of the patents’ behavior only increase their susceptibility to developing the problem in future. (Friedman et.al, 2010, P.p 408-410) Researchers have further described that war veterans often pass their inabilities on to their children because of their inability to control various aspects of their behavior such as angry outburst and the inability to distinguish between the past and the present. War veterans are so confounded by their problems and since they are so overcome with guilt and anger that they displace it all on their family member, and begin to see them as the root cause of their misery. Factors affecting vulnerability There are a number of factors involved that contribute to regulating the vulnerability of the individual. The most important contributor is one’s personality; for instance, if an individual is born with a propensity of brooding and ruminating over the negative aspects of his or her life then whatever they experience on the battlefield is likely to haunt them for a very long time. This indicates exactly the level of resilience an individual may possess and this is huge factor on deciding how soon an individual can overcome a setback and continue with his normal life routine. (Yehuda, 1999) Dr. Yehuda’s research provides immense amount of insight into this aspect of the disorder, examined the biological factors that increased the susceptibility of people to developing. Dr. Yehuda said, “Low cortisol levels are associated with PTSD. As might be expected, cortisol levels have been shown to be low in high-risk PTSD subjects immediately after trauma, or in those who actually develop PTSD at follow-up.”As a result, the parents transmit this trait of low cortisol levels in their offspring; hence this is one of the hypotheses that seek to explain as to why children exhibit behavior similar to that of a parent, who suffers from PTSD. (Yehuda, 1999, p. 93) Other factors include the traumatic incident the individual was exposed to; for example doctors in the army may also suffer PTSD while attending the patients at the hospital in extremely blood-spattered condition. However, the intensity of their symptoms may not be as severe as that of a soldier, who not only experiences such horrific incidents but is also ordered to afflict innocent civilians with all those injuries and wounds. The kind of social support an individual may have plays an important role in helping the individual to overcome the symptoms. As mentioned earlier, the individual feels alienated and isolated due to his experiences; the individual needs prior social support and to help him confide all his fears, which may effectively reduce anxiety and reduce his susceptibility to the disorder. Personal values and religious beliefs are also essential in determining the vulnerability of the individual to the disorder. Many people have very strong religious beliefs and often these religious beliefs may help the individual in overcoming the disorder; they may resort to praying and devoting their time to religious practices as a way to absolve them. This further increases their efficacy and as a result they are able to cope with their symptoms. On the other, people who do not have any religious beliefs, are agnostic or atheist, are more likely to experience the hopelessness or dejection that follows after they return from the military service. This aspect of vulnerability regarding PTSD is a huge component of one’s personality but spirituality plays an integral role, nevertheless. Chapter 3: Management of the disorder Considering the qualitative analysis of the disorder it is understandable that the disorder has a very pervasive impact; it causes dysfunctions not only for the sufferer but also affects the individual’s family and friends adversely. Out of all the disorders that are listed in the DSM-IV TR, PTSD requires intense counseling; as unlike other disorders, abnormal behavior PTSD has is completely in proportion to the etiology that is the source of the problem. Therefore, treatments suggested by the cognitive paradigm are not applicable, since the cognition triggering the abnormal behavior is not erroneous or irrational. Government programs focus more on preventing the development of this disorder by raising the mental threshold of individuals being recruited in the army. For this reason, many army recruitment centers screen all the candidates to make sure that there is no pre-existing condition that may get exacerbated as a result of witnessing bloodshed and combat on the battlefield. During their training, trainees are taught stress management and are mentally prepared for what they are about to witness, which enables them to manage their response to the stimuli. However, researches have shown that despite intense training the effects of this method were largely iatrogenic and did not reduce the number of individuals suffering from PTSD; as there was a major difference between preparing them what is to come and actually experiencing it. Drug therapy Clinicians prescribe various anti-anxiety and anti-depressant drugs to help alleviate the symptoms that were experienced by the client. The most popular drugs that are prescribed to the individual include the anti-depressant Prozac, anti-anxiety drug such as Benzodiazepines, anti-convulsants or anti-aggression drugs such as Carbamazepine and anti-psychotic drugs such as Risperidone. The administering of psychotropic drugs only provides short-term benefits to the individual and does not resolve the issues triggering the disorder. There is a high chance for addiction as well, therefore, drug therapy may not be as effective and may also give rise to certain side-effects that are more painful and distressing then the disorder itself. Cognitive-Behavioral therapy (CBT) Cognitive-Behavioral therapy (CBT) involves carrying out exposure therapy by helping the client talk about his or her feelings. The client talks freely about what he experienced on the battlefield and confide everything. The expression of their fears and troubles can give rise exaggerated responses such as full-blown panic attacks or crying spells; in order to reduce anxiety the client is taught relaxation technique and only once the individual master this the treatment regimen progresses. The client then systematically and gradually tells the clinicians about what exactly he or she witnessed and is then made to describe significant aspects of the events and wherever, the client feels overwhelmed they are taught to exercise relaxation and breathing technique which was taught to them earlier in order to reduce their anxiety. Stress Inoculation Training (SIT) is also an aspect of CBT that helps them to cope with the stress and anxiety by teaching the clients to manage them. CBT has been extremely effective in helping clients overcome the symptoms, however, this kind of treatment can take up a lot of time depending upon the openness and intensity of the client’s condition. However, the fact remains that CBT is the most efficacious way of dealing with the disorder. Support Groups and family therapies As the problem has become extremely widespread in recent years therefore there are support groups for soldiers suffering from PTSD. The ideology behind the establishment of support groups is to eradicate the feeling of isolation and alienation that comes along with the disorder. By giving them the social support with people who are suffering from the same ordeal the individual can effectively, as they can find individuals and can relate to them and also confide in them. Family therapies are also essential, as dealing with an individual suffering from PTSD can be a tedious task and also can have detrimental repercussions on the psychological well-being of children. These therapies are effective in alleviating the impact of the disorder and are also a very effective in helping the individual manage the disorder. (Herzog, 2008, p. 90) Conclusion In conclusion, the prose has established exactly how the disorder affects the life of an individual and affects not only his character and personality but also has a profound impact on their children. There is not only genetic diathesis involved in the transmission of the symptoms but the hypothesis suggested by Behaviorists is also very plausible. Children are highly impressionable and tend to learn or model their behavior according to the behavior exhibited by their parents. Therefore, immediate clinical attention must be given to all individuals and the individual must be taught to manage their symptoms effectively, in order to avoid exacerbation of the symptoms that is not only debilitating for the individual but others around him or her as well. References Friedman, M. J et.al. 2010. Handbook of PTSD: science and Practice. Guilford press: P.p 60, 408-410 Herzog, J.R. 2008. Secondary trauma in family member of war veterans. University of South Carolina: p. 90 Hunter, W.S. 2001. Psychological Abstracts, Volume 88. American Psychological Association: p. 345 Walck, B.M et.al. 2008. In retrospect: After their military discharge, what factors enabled combat Vietnam veterans to obtain a college degree and live a successful life, as defined by them? ProQuest: p. 19 Yehuda, R. 1999. Risk Factors for Posttraumatic Stress Disorder. American Psychiatric Publication: p. 93 Read More