Brain Damage and PTSD - Research Proposal Example

BRAIN DAMAGE AND PTSD al Affiliation Background War is a critical engagement that does not end with the stop of guns t the battle field. More than 17,530 US troops in 2009 were hospitalized for mental disorders. Traumatic brain injury is the most prominent injury that occurs in war with more than 50% of all combat related casualties a result of brain injury. With the advances in treatment and evacuation, however, more wounded soldiers are surviving than they did just a few years ago. However, hundreds of thousands are coming home and suffering from posttraumatic stress disorder with a significant percentage of those who are suffering not realizing they have a condition (Lawhorn & Philpott, 2010). Good treatment centers now exist that can help wounded warriors with traumatic brain injury, and control the adverse consequences that PTSD can occasion in a human life. Recently there has been focus and intention to focus on the consequences of PTSD. There is the perception that it is something experienced and then it goes away. Many soldiers come home exhibiting a wide range of symptoms but do not realize that what they are experiencing is PTSD. PTSD and traumatising brain injuries have a number of symptoms that may not seem relevant, but will affect the quality of life of an individual who is suffering. Many of the psychological disorders that soldiers suffer, including PTSD, may come from physical injuries they have endured (Lawhorn & Philpott, 2010). Vasterling, Bryant & Keane (2012) discuss the need to increase research and attention on stress-related psychological disorders due to the wars in both Afghanistan and Iraq. There is a strong belief that there is an intersection between traumatic brain injury and PTSD. Both of these problems are often considered invisible injuries because they are not easily observed in those who suffer. In symbolic comparative analysis, it would be safe to assert that TBI and PTSD are similar, because the affected people may not appreciate that they are affected and need help. It is essential to understand how these two conditions exist concurrently. This has a great deal of impact on both military and civilian health issues. In general terms, PTSD runs in about 7% to 8% of the population in the United States. This is much higher in some groups such as those who have been victims of violence particulalry the military service. In addition, TBI occurs in about 1.1 million people who end up in emergency rooms across the United States. Shockingly, this may actually be a low estimate as many people with traumatic brain injury that occurs at a milder level have few symptoms and do not seek care. Some people lose consciousness over only brief periods of time and do not feel the need to seek care. However, the estimated amount of TBI and PTSD in soldiers who were in Operation Enduring Freedom and Operation Iraqi Freedom is estimated to be between 13.8% and 19.5% assigned to each. It is difficult to have exact figures and it is also difficult to determine numbers due to the variations in how PTSD and TBI are defined. It is critical that definitions be made so that practitioners can address the issues with understanding and comprehension (Vasterling, Bryant & Keane, 2012). One of the biggest problems in addressing this issue has been that hospital policy concerning TBI and PTSD have been categorized as psychiatric problem, and thus a psychiatric approach is needed to address it. There are main issues that create barriers to continuing quality of life in those who suffer from TBI and PTSD. The first presumption is that they struggle with social anxiety and the struggle to fit in the society; the second is that they have cognitive impairments especially concerning attention and memory, and the third is that they have anxiety about returning to college or getting additional training because of the injuries they suffered. Developing treatments for people who have concurrent TBI and PTSD will help soldiers and citizens in being able to get back to a more meaningful life because the issues that they are facing have been addressed. However, because of stigma that exists about mental issues, some patients do not even seek treatment because they fear the stigma that may arise afterwards. As matter of fact and principle, there is the overall feeling and inference that people who witness traumatizing events in the course of their lives must experience some form of trauma afterwards. A practical case and instance is the soldiers and military men who return to their normal lives after wars. Thus, the line and area of interest is usually to gauge with utmost precision and accuracy the extent of the trauma. This is question the effects of the trauma on the soldiers who have returned from active wars. This logic and line of thought seeks to articulate that PTSD is an irreducible minimum in soldiers from war and thus interest should be to gauge its extent on the soldiers. A specific focus and attention is given to soldiers who might have accrued brain injury relative to the notion of PTSD as articulated herein. Methods This study uses secondary research in order to make connections between ideas and concepts that can illuminate the topic. Through search of databases and online book resources, the development of a rich foundation of resources can help to explore the subject matter. Using keywords to define the search, the literature can be used in order to determine how connections can be made between PTSD and TBI. Once the literature was accumulated and reviewed, the information from those works was put into context with the research questions and concepts were developed by creating connections between those works. This essay will therefore focus on the existing body of knowledge that has addressed the concepts of PTSD in details. Specifically, I would draw a keen and focused comparison or analysis between the effects of brain damage and the consequences or effects of PTSD, the level of damage and mitigative roles to combat the situation. Findings The effects of war are often very lessen, some factions wanting to downplay those effects in order to support your efforts and others wanting to inflate them in order to support peace. There is a disagreement in terms of persistent post concussive symptoms that are reported by Iraq combat veteran who have had repeated episodes of mild traumatic brain injury from being in close proximity to explosive blasts. This represents functional and structural brain damage and may also present with epiphenomenon of comorbid posttraumatic stress disorder (Sayer, 2012). Peskind et al (2011) conducted a study with 12 veterans from the Iraqi war who had experience one or more exposures to blasts and use a control group of 12 community volunteers. The veterans showed signs of decreased cerebral metabolic rates of glucose within the vermis, pons, cerebellum and medial temporal lobe. There were also impairments, although slight, in terms of cognitive processes, attention, verbal fluency, and working memory. Th impairments are very similar to the effects of cerebellar lesions. Brain imaging also found that there were chronic post concussive symptoms with the Iraqi veterans. Existing empirical data and evidence stiupualte that onset of PTSD can follow an incident of mild TBI. After an event of mild TBI, a longitudinal study on civilians found that 40% could recall the details of the injury two years after it occurred, where one month after the memory was not available to them. Delayed onset of PTSD is considered to be more common in the military than civilian settings and the reconstruction of the dramatic experiences can contribute to the delayed nature of the stress. There is speculation that trauma memory reconstruction in a post-deployment time is a contributing factor to the development of delayed PTSD (Bryant, Castro & Iverson, 2012: Carlson et al, 2010). Taylor et al (2012) has determined that genetic brain injury is a ‘signature injury’ that is symbolic of the Afghanistan and Iraq wars. Observations of patients with combat related traumatic brain injury shows that there are high rates of psychiatric pain and disturbances that accompany this type of injury. In 2009 there were approximately 327,388 veterans from these two conflicts and 6.7% of them had been diagnosed as having received a mild TBI. Of those diagnosed with a mild TBI, 89% were co-diagnosed with a psychiatric disturbance. Of that 89%, 73% were diagnosed with PTSD. Another 70% of the veterans had back, head, and neck pain. The longitudinal effect on veterans of the Iraqi and Afghanistan conflicts in terms of brain injury and posttraumatic stress disorder are yet unknown. In a study done by Polusny et al (2011) 950 National Guard soldiers were studied in order to assess the effects of MTBI and he TSD in terms of physical symptoms, depression, alcohol use, quality of life issues and overall social function. The results showed that soldiers who had concussion or MTBI were more likely to report post-deployment symptoms and poor psychosocial outcomes. The conclusions of the study determined that combat related PTSD was associated with post concussive symptoms and consequential psychosocial outcomes with a long-term negative impact for outcomes related PTSD. The outcomes reported by Polusny et al (2011) might be explained by some of the discoveries by Petrie et al (2014) where relationships were studied between the cerebral glucose metabolism in veterans with blast injuries and comorbidities with both depression and post back stress order. Participants exhibited abnormalities in the structure of their brain which is congruent with evidence that is being compiled about the neuropathological issues that accompany chronic brain injury in these types of veterans. This is consistent with work done by Pham et al (2014) which showed that disposing rats to a shockwave pressure of different intensities led to increase prion protein in the plasma and was potentially responsible for the comorbidity of psychiatric issues. Because visual symptoms such as lesions are not usually found when imaging MTBI, researchers depend on a great deal on histories of behavioral symptoms which are endemic of posttraumatic stress disorder and depression. In a study conducted in order to determine physical markers for neurological diagnoses of issues related to MTBI, high angular resolution diffusion imaging showed that white matter (Morey et al, 2012, p. ). Losses to primary fibers in the white matter was specifically associated with chronic mild TBI where distribution patterns of major fiber bundles and each smaller tracts in the peripheral, which included the corpus callosum and a number of other aspects correlated with MTBI that not with PTSD or depressants. However, impact related MTBI was associated with inflammatory and neurochemical events in the participants (p. 2986). Therefore there is some dispute whether or not comorbidity reflects a relationship between mild brain trauma and posttraumatic stress disorder. From these findings, one would safe to infer a high positive correlation relative to brain damage and prospects of suffering PTSD. It then follows that the case studies point to the direction of prospects of PTSD especially if soldiers from war are to ever recovery to their previous modes of health. Discussion Most studies show that there is comorbidity between MTBI and PTSD. However, finding a causal relationship has yet to be proven. For instance, according to Carlson et al (2011) where evidence was collected along studies published between 1980 and 2009 the outcome was that across 34 studies no accurate treatments or diagnosis was possible in terms of connecting MTBI and PTSD. The however, in the 5 to 7% of former soldiers who returned from wars such as in Afganistan and Iraq, both MTBI, there was a prevalence of PTSD in 33 to 39% of the cases. This suggests that there is a distinct possibility of discovering a connection between these two issues. The changes that have been observed in brain structure would indicate that some effect is likely to have occurred. The presence of more traumatic brain injury in the recent worse than reported in previous wars suggests that this issue is of great importance to soldiers returning home. The development of more concentrated blasts that occur more frequently has made this issue one of 21st century warfare more than any other time (Ling, 2013). While PTSD has been part of warfare throughout history, the development of PTSD as a condition of MTBI may either be a modern warfare manifestation or the development of signs of knowledge on the topic. Men who are returning home to face social normalcy after being in the theater of war often become either depressed or manifests PTSD. Delayed onset of PTSD is more common in soldiers than it is in civilians. In addition, stress disorder such as PTSD are becoming more commonly understood and appreciated, if the increased societal awareness is anything to go by. For instance a lot of attention is given relative to the issue of PTSD in soldiers returning from war. The resilience of the human mind to withstand the effects of stress has often shielded researchers from being able to draw conclusions, but emerging neuroscience research has capacity to begin to understand physical aspects of brain trauma and associated psychological effects (National Research Council (U.S.), 2009). Subsequently, it implies that because there is irrefutable claims and empirical evidence to explain the correlation between brain injury and PTSD in soldiers from war, then approach mitigative measures ought to be taken. Thus, measures and approaches ought to be taken to cure the physical brain damage and injury plus the psychological injury that would accrue thereon. Through continued research on this topic the potential for changing the nature of modern warfare exists in order to protect soldiers from the effects of mild brain trauma as well as PTSD. The study was limited in terms of scope and length which meant that conclusions cannot be drawn in terms of neurological studies without a much longer and more in-depth examination. Further research can be conducted on this topic based on the findings that report comorbidities exist between MTBI and PTSD. Understanding that neurological effects of blasts have an effect on psychiatric conditions is a basis for understanding the experiences of soldiers. Further research should be conducted examining the brain after mild brain trauma and the delayed emergence of PTSD Reference Vasterling, J. J., Bryant, R. A., & Keane, T. M. (2012). PTSD and mild traumatic brain injury. New York: Guilford Press. Read More