Post-traumatic Stress Disorder in Young People - Essay Example

POST-TRAUMATIC STRESS DISORDER IN YOUNG PEOPLE By (school) Post-traumatic Stress Disorder in Young People Introduction Post-traumatic stress disorder (PTSD) is one of the most common disorders afflicting most people at any age group. It can affect almost any person as they go through traumatic events in their life. It is also pervasive because it tends to affect almost all aspects of a person’s life – from his social, work, to his family life. Among young people, its impact is even more devastating as these individuals often do not have the emotional maturity to deal with trauma. This paper now seeks to discuss the onset and clinical picture of PTSD in young people based on literature and case examples. This critical review is being undertaken in the hope of establishing a clear and comprehensive understanding of PTSD and its impact on young people’s lives. Discussion Post Traumatic Stress Disorder is usually seen after a major disaster or traumatic experience. Several studies assessing emotional responses were carried out in the wake of the September 11, 2001 World Trade Center attacks. In a paper by Adams and Boscarino (2006, p. 485), the authors set out to identity the factors associated with PTSD following the World Trade Center Disaster (WTCD) and the changes in PTSD status which were seen over time. This study was a prospective cohort study of New York City adults living in the city on September 11, 2001 and was conducted a year after the attacks and another year after that for follow-up. About 2000 individuals were covered in the first survey and 1600 on the second survey (Adams & Boscarino, 2006, p. 485). The study revealed that in the year immediately following the WTCD, younger females who experienced previous trauma and negative life events, and who had low self-esteem had a greater possibility of developing PTSD (Adams & Boscarino, 2006, p. 485). In the second year following the September 11 attacks, those who were middle-aged, Latinos, who experienced previous trauma and negative life events, and those who had low self-esteem were more likely to develop PTSD (Adams & Boscarino, 2004, p. 485). The study was able to point out crucial qualities in individuals which made them vulnerable to PTSD after a significant trauma like the September 11 attacks. This study is a peer-reviewed research conducted by reputable experts in the field of psychology and psychiatry. The study presented in detail the different characteristics present among respondents which make them vulnerable to PTSD. The authors were able to draw an analysis based on reliable statistical results. These results were also related and founded on findings from previous studies. The methodology applied by the authors was appropriate to the study and the questions raised by the study. This study is relevant to this paper because it was able to establish patterns of behaviour and characteristics in individuals that can later help health care professionals identify individuals more vulnerable to PTSD. The study above was able to point out that even as all individuals go through some type of trauma at one point in their lives, some, more than others, have a greater predilection of experiencing PTSD. Those vulnerable to PTSD are individuals who have experienced previous and trauma and who are less emotionally equipped to handle its mental impact. In a study by Shalev and Freedman (2005, p. 1188), the authors pointed out how previous and continuous trauma can make some people more vulnerable to PTSD. In their study, they covered 39 survivors of terrorist attacks and 354 survivors of motor vehicle accidents who were assessed for PTSD symptoms at 1 and 4 months (Shalev & Freedman, 2005, p. 1188). The study revealed that terrorist attack survivors manifested with higher rates of PTSD as compared to motor vehicle survivors (Shalev & Freedman, 2005, p. 1188). However, regardless of the type of trauma, the victims manifested with similar levels in heart rate and early PTSD symptoms. The authors concluded that early symptoms can be used as indicators of PTSD. The combined effects of terror-induced fear, adjustment, and an individual’s resiliency are factors which affect the impact of a terrorist attack on victims. This study is a peer-reviewed research with authors being reliable researchers and mental health practitioners. Based on these qualities, this paper is very much reliable. It presents assumptions which were used to lay out the foundations and basis of this research. A hypothesis was drawn based on the trends and possibilities as presented by previous studies. The methodology utilized by the authors is appropriate for this research because it effectively gave the authors valuable tools for finding evidence and establishing results. The results drawn are appropriately established based on evidence as revealed from the statistical processes. This paper is relevant to this literature review because it helps predict trends and patterns of behaviour among trauma victims and how such patterns can be used to prevent and identify potential sufferers of PTSD. Some types of trauma also tend to impact greatly on some people as compared to some other types of trauma. In a paper by Collin-Vezina and Hebert (2005, p. 47), the authors sought to compare the symptoms of dissociation and of PTSD in a group of sexually abused school-age girls. Based on statistical analysis and correlation, the study revealed that sexual abuse impacts greatly on victims and increases their chances of later presenting with dissociation and PTSD by eightfold and fourfold respectively (Collin-Vezina & Hebert, 2005, p. 47). The study also presented a higher percentage of dissociation (as compared to PTSD) manifesting among sexually-abused children. Nevertheless, the research was able to reveal that the PTSD which manifested among the respondent children still reached clinical significance (Collin-Vezina & Hebert, 2005, p. 47). Moreover, the authors also emphasized that for children with previous trauma and other negative life experiences, the chances of developing PTSD manifested at a higher percentage (Collin-Vezina, 2005, p. 47). This is a peer-reviewed study which was conducted by reliable and credible researchers who are technically skilled in their professional mental health practice. The study they conducted is based on assumptions drawn from evidence-based research. The methods chosen were appropriate for their research and were able to evaluate figures and results using logical regression and multivariate analyses between dissociation and PTSD. The results drawn were based on accurate statistical analysis. The conclusions which were established were also based on the logical progression of ideas from the hypothesis, to the results, and on to the discussion points. This paper was chosen for this study because it presented a clinical picture of PTSD and its impact on the victims. It also presented a more comprehensive and evidence-based picture of PTSD. The impact of trauma among children was further assessed in a paper by Bronner and colleagues (2008, p. 9) where the authors conducted their study in order to evaluate the presence of PTSD among children who have undergone paediatric intensive care treatment and among those who have gone through the fire disaster in the Netherlands (Bronner, et.al., 2008, p. 9). The authors established in the course of their research that more than a third of the children who were included in this study manifested with subclinical PTSD and 13.8% manifested with full-blown PTSD (Bronner, et.al., 2008, p. 9). They also noted how the presence of maternal PTSD was the highest predictor for a child having PTSD. The authors concluded that a significant number of children manifested with persistent PTSD after PICU treatment. They also pointed out the importance of preventing PTSD in order to minimize its impact on the children’s well-being and future development. This paper is another peer-reviewed research conducted and written by credible practitioners with excellent qualifications and expertise in mental health practice. The research question that they raised is contemporary and is relevant topic to the current enrichment of PTSD knowledge. The assumptions raised are also based on valid and evidence-supported statements. The research methodology is also appropriately chosen for this paper; it helps establish accurate answers to the questions raised by the researchers. The results are also based on accurate and appropriate statistical tools. The conclusions drawn are clear and are based on the results as proven by the tools applied in the research process. This paper is relevant to this literature review because it provides a clinical picture of the risk factors related to PTSD among children, and the prevalence of PTSD among traumatized children. In seeking a more genetic-based assessment of PTSD, authors Nugent, Amstadter and Koenen (2009, p. 127) conducted their literature summary of evidence on the genetic influences on PTSD. They discussed the specific contributions to their understanding of the genetics of PTSD based on twin studies. They also summarized findings from molecular genetic studies which helped to improve the understanding of biological mechanisms in the development of PTSD (Nugent, Amstadter, & Koenen, 2009, p. 127). In essence, they were able to ascertain that based on diverse research sources, strong support is credited to the genetic influence in the aetiology of PTSD. Studies involving families have presented an indication of a higher risk for PTSD among relatives (Nugent, Amstadter, & Koenen, 2009, p. 127). Furthermore, the authors were also able to unveil studies which supported the heritability of PTSD based on twin relations. The authors were however quick to point out that no evidence on the genetic underpinnings of such results and trends were established as yet (Nugent, Amstadter, & Koenen, 2009, p. 127). This study is also a peer-reviewed research conducted by credible authors. The research process is, however, not thorough and scientific enough to be used as basis for evidence-based practice. The authors themselves point out that the gene studies utilized a limited number of samples which do not provide sufficient basis for actual practice. The research provides tentative answers and future basis for research. Moreover, it also needs specific details and primary research materials in order to attain improved credibility as a tool for actual practice. Research also indicates a strong link between parents and children in the onset of PTSD. In their study, Thabet and colleagues (2008, p. 191) sought to determine the relationship between ongoing war traumatic experiences, PTSD and anxiety symptoms among children, while considering parents’ mental health responses. The authors were able to establish in the course of their research that children and parents who experienced traumatic events manifested high levels of PTSD and anxiety (Thabet, et.al., 2008, p. 191). For children, trauma often meant high PTSD and anxiety scores and parents’ emotional experience of trauma also meant increased PTSD and anxiety symptoms (Thabet, et.al., 2008, p. 191). The authors concluded that war trauma impacts both on parents’ and on children’s mental health and the emotional reaction of parents and children are often closely associated with each other. The authors concluded that in effecting solutions for PTSD, such solutions should include both parents and children. Solutions should not be exclusive to the parents or the children alone. This paper presents logical assumptions drawn from previously established facts. The methods of research are appropriate for this study and are thorough enough to cover all the different variables and questions raised. The conclusions established are also based on the results, discussions of literature, and on strong evidence. The strong link between parental PTSD and the occurrence of PTSD among children has also been noted in a study by Yehuda, et.al., (2009, p. 1104). In their research they sought to assess the contribution of maternal versus paternal PTSD in the manifestation of symptoms in relation to PTSD and other mental health disorders. In a study of 117 and 167 men assessed for traumatic life experiences, 211 of respondents were revealed to be adult offspring of holocaust survivors (Yehuda, et.al., 2009, p. 1104). After undergoing the analytical research process, the study revealed a higher rate of lifetime PTSD, mood and anxiety disorders among the offspring of Holocaust survivors (Yehuda, et.al., 2009, p. 1104). Maternal PTSD was also identified as having a stronger association with PTSD in adult children. Nevertheless, the study also revealed that PTSD in any of the parents presents a higher risk of depression, PTSD, and other anxiety disorders manifesting in their children (Yehuda, et.al., 2009, p. 1104). In further assessing the impact of PTSD on children, Dekel and Goldblatt (2008, p. 281) sought to evaluate the intergenerational transmission of PTSD among fathers to sons among war veteran families. Their study was a review of various researches assessing the type of fathers who had a greater tendency to transmit distress to their offspring; how such distress was transmitted; and the type of children who were more vulnerable to transmission of PTSD distress within the family (Dekel & Goldblatt, 2008, p. 281). The study established that a major contributor of children’s trauma is a father manifesting symptoms of PTSD. Fathers who experienced abuse and torture during war were also more likely to manifest violent behaviour. Such violent behaviour and distress often has often resulted to great distress among their children as well (Dekel & Goldblatt, 2008, p. 281). The authors recommended that it is important for a therapeutic intervention for traumatized veterans to also include children and other family members (Dekel & Goldblatt, 2008, p. 281). These family members have a high risk of later experiencing PTSD and anxiety due to the behaviour manifested by their fathers returning from war. This paper is another peer-reviewed paper by experts in the field of mental health. The review process is based on updated literature, as well as a thorough analysis of relevant studies. The reliability of this research is evidence-based and fully narrowed down based on limitations identified by researchers. In presenting a clinical picture of PTSD, a paper by Armony, et.al. (2005, p. 1961), utilized functional magnetic response imaging in order to determine amygdala response among patients with acute PTSD to emotional expressions. In the course of their study they were able to establish a correlation between the severity of PTSD and the different amygdala changes from masked fearful to happy faces (Armony, et.al., 2005, p. 1961). They also established a negative relationship between unmasked fearful and happy faces. In effect, the authors concluded that functional abnormalities in brain responses to emotions seen in the chronic phase of PTSD are usually often apparent already in its acute phase. This study was able to detail assumptions about the subject matter and to draw facts based on solid findings in the study. The discussions made by the authors were also based the study results and on previous related studies. Moreover, the conclusions drawn by the authors were based on results established during the course of the research and based on trends seen in similar studies. This study is relevant to the main topic because it gives a clinical picture of PTSD – that a neurological response or affect is already evident in the earliest stages in a patient’s life. In assessing effective interventions for PTSD, Cohen and colleagues (2004, p. 393) carried out their study in order to evaluate the differential efficacy of trauma-focused, cognitive behavioural therapy (CBT) and Child Centred Therapy (CCT) in sexually abused children. The study covered 229 8-14 year old children with significant PTSD (and their primary caregivers) assigning them the two alternative treatments. The study revealed that children who were assigned to CBT showed more improvement as compared to the children assigned to the CCT treatment (Cohen, et.al., 2004, p. 393). They also exhibited less PTSD, depression, behaviour problems, shame, and abuse-related symptoms (Cohen, et.al., 2004, p. 393). Parents undergoing CBT (as compared to those who underwent CCT) also exhibited more improvements in dealing with depression and abuse-related distress (Cohen, et.al., 2004, p. 393). The authors concluded that based on the results of their study, CBT is more effective than CCT in managing PTSD among sexually abused children and their parents. The study is peer-reviewed and published in a reputable journal; hence is a highly reliable study for this subject matter. The study presents valid assumptions which were relevant to the discussions in the study. The results were also based on applicable and appropriate statistical analysis. This study was also able to specify specific evidence relevant to this study. This study is relevant to this paper because it helps point out effective therapeutic and behavioural interventions for PTSD – applicable to the needs of sexually abused children and their parents. Moreover, this study was able to arrive at logical conclusions supported by the results and by previous studies cited by this paper. In assessing the impact of PTSD among children, Masten and colleagues (2008, p. 139) conducted their study in order to evaluate the processing of facial emotions among maltreated children with high rates of PTSD. This study was undertaken based on the assumption that children with PTSD manifested difficulties in processing their emotions. The authors were able to establish in the course of their research that maltreated children as compared to controlled subjects had faster reactions in labelling emotional facial expressions, most especially in identifying fearful faces (Masten, et.al., 2008, p. 139). Maltreated children were also more likely to show emotional reactions in identifying fearful faces (Masten, et.al., 2008, p. 139). The authors concluded that maltreated children showed a higher ability to identify fearful emotions and expressions in people. This ability also implies a relationship between trauma and emotional reactions in children’s lives (Masten, et.al., 2008, p. 139). This paper is a peer-reviewed research and conducted by authors and researchers who specialize in the fields of psychology and mental health practice. The question raised is very much relevant in the current practice in relation to PTSD. The methods of research utilized are also appropriate in establishing answers to the questions raised by the researchers. Such methods were able to provide logical and evidence-based results which consequently provided strong and comprehensive answers to the questions. Conclusion Post-traumatic stress disorder is one of the most pervasive mental health disorders which affect most people going through traumatic experiences. As demonstrated above, some people are however more vulnerable to it. Those who have experienced previous trauma, have low self-esteem, are younger, and who are exposed to continuous trauma are more likely to be afflicted with this mental health disorder. Individuals who also have a family history and close family experience of PTSD also have a higher risk of later developing PTSD as compared to the general population. Its impact on children’s and young adult’s lives is pervasive in the sense that it makes these individuals more likely to develop heightened responses to anger and fear. Such responses can affect the growth and development of these children. Hence, interventions that mental health professionals implement should be based on cognitive behavioural therapy for the PTSD sufferer and for his family as well. Moreover, such interventions should be based on evidence-based practice and on sound mental health principles. Reference Adams, R. & Boscarino, J. (2006) Predictors of PTSD and Delayed PTSD After Disaster: The Impact of Exposure and Psychosocial Resources, Journal of Nervous and Mental Disease, volume 197 (7), pp. 485-493 Armony, J., Corbo, V., Clement, M., & Brunet, A. (2005) Amygdala Response in Patients With Acute PTSD to Masked and Unmasked Emotional Facial Expressions, American Journal of Psychiatry, volume 162, pp. 1961-1963 Bronner, M., Knoester, H., Bos, A., Last, B., & Grootenhuis, M. (2008) Posttraumatic stress disorder (PTSD) in children after paediatric intensive care treatment compared to children who survived a major fire disaster, Child and Adolescent Psychiatry and Mental Health, volume 2, p. 9 Cohen, J., Deblinger, E., Mannarino, A. & Steer, R. (2004) A Multi-Site, Randomized Controlled Trial for Children With Abuse-Related PTSD Symptoms, Journal of American Academic Child and Adolescent Psychiatry, volume 43 (4), pp. 393–402. Collin-Vezina, D. & Hebert, M. (2005) Comparing Dissociation and PTSD in Sexually Abused School-Aged Girls, The Journal of Nervous and Mental Disease, volume 193, (1), pp. 47-52 Dekel, R. & Goldblatt, H. (2008) Is There Intergenerational Transmission of Trauma? The Case of Combat Veterans’ Children, American Journal of Orthopsychiatry, volume 78(3), pp. 281–289 Masten, C., Guyer, A., Hodgdon, H., Maclure, E., Charney, D., Ernst, M., Kaufman, J., Pine, D., & Monk, C. (2008) Recognition of facial emotions among maltreated children with high rates of post-traumatic stress disorder, Child Abuse and Neglect, volume 32(1), pp. 139153 Nugent, N., Amstadter, A., & Koenen, K. (2008) Genetics of Post-Traumatic Stress Disorder: Informing Clinical Conceptualizations and Promoting Future Research, American Journal of Medical Genetics, volume 148C(2), pp. 127-132 Shalev, A. & Freedman, S. (2005) PTSD Following Terrorist Attacks: A Prospective Evaluation, American Journal of Psychiatry, volume 162, pp. 1188-1191 Thabet, A., Tawahina, A., Sarraj, E., & Vostanis, P. (2008) Exposure to war trauma and PTSD among parents and children in the Gaza strip, European Child & Adolescent Psychiatry, volume 17 (4), pp. 191-199 Yehuda, R., Bell, A., Bierer, L., & Schmeider, J. (2008) Maternal, not paternal PTSD, is related to increased risk for PTSD in offspring of Holocaust survivors, Journal of Psychiatric Research, volume 42(13), pp. 1104-1111. Read More