Post Traumatic Stress Disorder - Dissertation Example

? Post Traumatic Stress Disorder: Soldiers’ Fears of Medical Discharge from the Military Post Traumatic Stress Disorder: Soldiers’ Fears of Medical Discharge from the Military Introduction Background of the Problem The nature of military combat makes soldiers be predisposed to post traumatic stress disorder (PTSD) (Corso, Bryan, Morrow, Kanzler Appolonio, Dodendorf, & Baker, 2009). This assertion is based on an investigation that was carried on more than 2,500 soldiers who were back from Operation Iraq Freedom (OIF). The study was conducted in VA medical Center in San Francisco. The investigators found out that active engagement in combat and killing causes soldiers to suffer from PTSD and the related symptoms such as depression, substance abuse, relationship difficulties and anger. Congruent to these findings, investigation on soldiers returning from the Vietnam War demonstrated that the handling of bodies and killing the enemy caused soldiers to suffer from anxiety, depression and PTSD (Burke, Olney, & Degeneffe, 2009). Similar findings were collected by investigators of soldiers who participated in the First and Second World Wars (Mansfield, Williams, Hourani, & Babeu, 2010). The symptoms that soldiers in active engagement in these wars exhibited upon admission include hypersensitivity, headaches, lack of adequate concentration, tremor, amnesia and dizziness. These symptoms have been correlated by medical experts to PTSD (Polusny, Erbes, Murdoch, Arbisi, Thuras, & Rath, 2011). Statement of the Problem The fear for medical discharge causes soldiers returning from war to hide their PTSD symptoms. Moreover, these soldiers are likely to be incorporative with screening and therapy for PTSD (Corso et al., 2009). It is, however, notable that there is a gap in past research on this topic because the fears of soldiers for the diagnosis of PTSD have not been investigated upon. Data that was gathered from soldiers returning from active duty in the Afghanistan and Iraq wars can be used to perform a comparative analysis with primary data from soldiers diagnosed with PTSD. The unique problems, characteristics and medical symptoms that soldiers with PTSD have would be used to determine the level of their willingness in exposing these signs. The reasons why soldiers would want to conceal these signs by not participating in screening and therapy would also be used to confirm the hypothesis that they fear for medical discharge from the military. Purpose of the Study The purpose of the proposed study is to investigate whether soldiers prefer to hide their PTSD for the fear that they would be discharged from the military for medical grounds. The study purposes to determine how this fear would hinder diagnosis and therapy for soldiers with PTSD. Moreover, the proposed study determines effects of PTSD on soldiers returning from active participation in war. It is, therefore, the purpose of the study to point out the significant considerations that must be included in health care for the military. A theoretical framework will also be applied in the study with a view to determining the psychosocial aspects associated with the experiences of soldiers during war which leads to PTSD. Research Questions 1. Are soldiers willing to participate in screening and therapy for PTSD? 2. What are the reasons for declining counseling, screening and therapy among soldiers returning from war? 3. Do soldiers exhibit fear for medical discharge from the military? 4. In what ways can the health care for soldiers be improved for proper screening and management of PTSD? Importance of the Study Post traumatic stress disorder has significant long term effects on the lives of soldiers and their relatives. Regardless of these effects, the proposed research hypothesizes unwillingness of soldiers to participate in counseling, screening and therapy for PTSD. It is in this regard that a scientific investigation is important in determining the relationship between the soldiers’ uncooperativeness to screening and treatment and possible fears for medical discharge from the military. More importantly is the fact that PTSD and its symptoms require that proper health care be provided to soldiers. Therefore, the proposed study will be an important source of information for health care professionals for objective PTSD screening. Moreover, the study will be important in determining the behaviors of soldiers towards PTSD care. This will be used to provide appropriate recommendations for positive changes in the screening and care of soldiers with PTSD. Limitations and Delimitations The proposed study is limited to the previous research and existing data on the topic under investigation. Moreover, the amount of time allocated for the proposed study will limit the findings of the study and the sufficiency in the data analysis process. Furthermore, the study is limited by the assumption that the scientific methodology of previous research on the topic was applied effectively to achieve accurate results. Moreover, the proposed study is limited to data on soldiers who have already been diagnosed with PTSD. Furthermore, the proposed study does not include trauma that soldiers experience from injuries such as falls, vehicle and motor cycle accidents. As will be described in the methodology section, the proposed study is limited to secondary sources of information. Review of Literature A PTSD prevalence of 12.5% was established by research on veteran soldiers who had participated in the Afghanistan and Iraq wars (Corso et al., 2009). A study that was conducted in Seattle VA hospital disclosed that the physical health problems of soldiers of war were connected to the symptoms of PTSD (Burke et al., 2009). This study was based on questionnaires and interviews as methods of data collection. The investigation focused on the soldiers with physical injuries, whether they had PTSD or not. The researchers further found out that the physical injuries that the soldiers sustained in the war in addition to the experiences of active combat highly contributed to the 13% prevalence of PTSD that was found among this group of participants (Mansfield et al., 2010). The experiences of soldiers at war which were found to have contributed to the PTSD include exposure to chemicals such as uranium and biological exposure such as anthrax (Creamer, Wade, Fletcher, & Forbes, 2011; Walker, 2010). It is through this study that it is evident that in addition to the problems of readjustment, soldiers face numerous health challenges which predispose them to the development of PTSD. The Journal of Military Medicine published findings of a recent PTSD survey on more than 100 soldiers returning from active combat in Iraq and Afghanistan (Corso et al., 2009). The reported study was focused on soldiers with symptoms of PTSD, substance abuse, depression in addition to those who were seeking mental health services at VA hospitals. The results of the study reveal that alcohol abuse was the commonest symptom among soldiers returning from active combat with 27.5% incidences. More significantly, 6.5% of the respondents revealed PTSD symptoms (Polusny et al., 2011). The study also found out that more than 90% of soldiers with PTSD symptoms had a drug problem (Burke et al., 2009; Walker, 2010). This research illustrates that soldiers returning from active combat are faced with readjustment problems which contribute to the development of PTSD. It is notable that the investigation had a gap in its findings. This is due to the fact that it failed to demonstrate the fears that the soldiers had in case of them being diagnosed with PTSD and the related symptoms. Investigators of the effects of the First and Second World Wars on the lives of soldiers disclosed that psychological wounds are the common characteristic among these soldiers (Khaylis, Polusny, Erbes, Gewirtz, & Rath, 2011). These soldiers revealed symptoms of depression, emotional imbalance, and difficulties with intimate relationships, anger, low self-confidence and substance abuse (Polusny et al., 2011). These studies specifically found out that more than 80% of these symptoms were related to PTSD (Corso et al., 2009). In accordance with psychiatric evaluation, it is estimated that one of every three soldiers who participated actively in the Afghanistan and Iraq Wars develop PTSD and the related symptoms. More importantly, investigators of PTSD disclose that only 50% of the soldiers with PTSD are able to receive proper health care to meet their psychological needs. Nonetheless, these studies describe lack of adequate resources as the reason why the soldiers have not received proper care. This illustrates that there is a gap in knowledge on the relationship between the fears of soldiers for medical discharge from the military and the low participation in health care programs for the management of PTSD. Empirical studies on veterans of the Iraq and Afghanistan wars reveal that the psychological issues that these soldiers face are likely to increase with time (Mansfield et al., 2010). This is so especially when this condition is not managed effectively. The commonest diagnosis among soldiers returning from war is brain injury which results in depression and PTSD (Creame et al., 2011). The Department of Defense reveals that more than 26% of American soldiers returning from war have psychological issues and mental health problems (Corso et al., 2009). Nonetheless, these statistics do not disclose the level of participation of these soldiers in screening and the possible fears that they would be facing in relation to diagnosis of PTSD. Furthermore, it is postulated that over time, the mental health needs of soldiers of war increase significantly (Burke et al., 2009; Walker, 2010). It is, therefore, necessary to promote early screening and treatment for PTSD so that the increased needs for mental health and care are reduced. This can be achieved through an understanding of the fears of soldiers for the diagnosis of PTDS and participation in treatment. If the fears of the soldiers are understood, the mental care programs will be designed to cater for the privacy of patient information upon being diagnosed with PTSD. This will improve the level of participation in screening and treatment of this disorder. In return, the increasing needs for mental health and care will be reduced significantly. Methodology Research Methods The research methodology that is proposed for the study will be focused on investigating and determining with accuracy if soldiers hide their PTSD symptoms to avoid medical discharge from the military. It is through this that the invisible psychological problems and mental wounds among soldiers can be investigated further for effective management if PTSD. In this regard, the proposed research will employ secondary research methodology. The secondary research methodology, on the other hand, will enable the investigator to gather data from secondary sources of information which report existing data from previous studies on the topic. This data will be useful for analysis, and hence achievement of the objectives of the study. The specific tools that will be used to gather secondary data and information will be described in the later sections of the methodology. Study Design The proposed investigation will make use of both qualitative and quantitative research designs. The qualitative research design will enable the collection of qualitative data and information on the topic for analysis and interpretation. A qualitative research design is recommended for the proposed study because it allows in-depth investigation and understanding of the issue under study (Goddard & Melville, 2006). Moreover, the issues that cannot be quantified in the study of soldiers’ fears in the diagnosis of PTSD can only be achieved effectively through a qualitative research design. The use of a quantitative research approach is effective in the collection and analysis of statistical or quantifiable data on the topic. This includes the number of soldiers diagnosed with PTSD and the percentages of participation in screening and mental care programs. Quantitative research approach is described as a viable and effective method of describing statistical data and drawing conclusions based on this data (Kothari, 2005). Case Study A case study will be selected from existing data on the topic under investigation with an aim of achieving specificity in the investigation. Past data on soldiers who had actively participated in the Afghanistan and Iraq Wars will be selected as the case study for the proposed research. The use of a case study method is motivated by the fact that case studies allow investigations to explore deeper into a set of complex issues (Singh, 2006). In this case, the symptoms, effects, fears and psychological needs of soldiers will be investigated. Moreover, a case study approach is recommended for the proposed research because it allows collection of detailed information about a study topic (Goddard & Melville, 2006). More specifically, the case study will limit the scope of the investigation to manageable proportion. Furthermore, the case study will allow generalization of the soldiers’ fears of PTSD diagnosis from the Afghanistan and Iraq War cases. Therefore, the investigation will rely on the case study from existing data as the source of information for interpretation and presentation of finding during the course of the proposed study. Study Population The study population will include soldiers who have returned from active combat in Afghanistan and Iraq. Data on the study population will be gathered with a focus on accuracy and specificity in accordance to the objectives. The target population will also comprise diverse groups to define the characteristics of a study population, such as age, gender, education levels, income and social cultural affiliation. Sampling Frame A random sampling technique will be employed within the proposed study. This will include random selection of participants during the process of the survey. The random sample will be selected from the study population and hence the participants will include both female and male soldiers who are diagnosed with PTSD on their return from active combat in Afghanistan and Iraq. Informed Consent Data for the study will be obtained from secondary sources of information on the research topic. As a result, the proposed study will authenticate for informed consent within the primary studies before making use of the data for analysis, interpretation and recommendations. This is due to the need to adhere to the legal and ethical frameworks of research which stipulates that participants should participate in a study voluntarily. Confidentiality The confidentiality of the participants will be defined during the survey process. This is to ensure that enlisting of participants during the primary studies secures the privacy of personal data collected from the participants. Instrumentation in Data Collection Data collection will be focused on secondary sources of information on the topic. These include online databases, journal articles and medical reports. The collection of data from online databases will employ search strategies such as Boolean Search Strategy. This is because of the effectiveness of such search strategies in narrowing down the search into the specific area of study. Keywords will, therefore, be used to narrow down the focus of the study in order to meet the objectives of the study. The proposed data collection technique will use Post Traumatic Stress Disorder, Military, Soldiers, Fears, Screening and Medical Discharge as the major key works for data collection. The online databases that will be targeted by the data collection include Ebsco, Proquest and PubMed. Through the proposed data collection methods, it is expected that sufficient and accurate data will be collected from previous research reports. This data will be analyzed and interpreted as described in the following sections. Validity and Reliability The data collection and analysis processes will be aimed at meeting the objectives of the study. Nonetheless, the validity and reliability of the gathered data will be ensured. This is through the use of credible sources of information which will confirm that the data is valid. In this regard, both internal and external validity will be authenticated. More importantly, the accuracy of the gathered data will be the central focus of the study so that the data collected and analyzed would be reliable for practical application. Data Analysis and Presentation The analysis of the collected data will be achieved through coding and comparative analysis methods. Coding involves categorization of the collected data into common classes for ease in interpretation. Both qualitative and quantitative data from secondary sources of information will be grouped into related classes depending on the commonalities among the data. Through coded findings, the analysis of secondary data is facilitated (Goddard & Melville, 2006). In addition, the analysis of the collected data will be achieved through statistical packages such as Microsoft Excel. This will enhance the speed into which data is analyzed, categorized and interpreted into meaning. More importantly, the secondary data will be analyzed with a view to answering the research questions. In addition, comparative analysis approach will be used during the data analysis stage of the study. This will involve comparison of secondary data from various sources to determine correlation and gaps. This will enhance the depth of discussion of the research findings. The presentation of data will be achieved through tabular and graphical forms. Tabular representation of data is proposed because the use of tables allows presentation of a large amount of data within a single table (Kothari, 2005). Graphical presentation of data will allow the investigator to depict the research findings in form of graphs and charts. This is because of the ease of interpretation of research findings which is enabled by the application of graphical presentation. References Burke, H. S., Olney, M. F., & Degeneffe, C. E. (2009). A new disability for rehabilitation counselors: Iraq war veterans with traumatic brain injury and post-traumatic stress disorder. Journal of Rehabilitation, 5–14. Corso, K. A., Bryan, C. J., Morrow, C. E., Kanzler Appolonio, K., Dodendorf, D. M., & Baker, M. T. (2009). Managing posttraumatic stress disorder symptoms in active-duty military personnel in primary care settings. Journal of Mental Health Counseling, 31(2), 119–136. Creamer, M., Wade, D., Fletcher, S., & Forbes, D. (2011). PTSD among military personnel. International Review of Psychiatry, 23(2), 160–165. Goddard, W., & Melville, S. (2006). Research methodology: An introduction. Lansdowne: Juta. Khaylis, A., Polusny, M. A., Erbes, C. R., Gewirtz, A., & Rath, M. (2011). Posttraumatic stress, family adjustment, and treatment preferences among National Guard soldiers deployed to OEF/OIF. Military Medicine, 176(2), 126–131. Kothari, C. R. (2005). Research methodology: Methods & techniques. New Delhi: New Age International (P) Ltd. Mansfield, A. J., Williams, J., Hourani, L. L., & Babeu, L. A. (2010). Measurement invariance of posttraumatic stress disorder symptoms among U.S. military personnel. Journal of Traumatic Stress, 23(1), 91–99. Polusny, M. A., Erbes, C. R., Murdoch, M. M., Arbisi, P. A., Thuras, P. P., & Rath, M. B. (2011). Prospective risk factors for new-onset post-traumatic stress disorder in National Guard soldiers deployed to Iraq. Psychological Medicine, 41(4), 687–698. Singh, Y. K. (2006). Fundamental of research methodology and statistics. New Delhi: New Age International. Walker, S. S. (2010). Assessing the mental health consequences of military combat in Iraq and Afghanistan: a literature review. Journal of Psychiatric & Mental Health Nursing, 17(9), 790–796. Read More