Post traumatic stress disorder - Research Paper Example

?Post traumatic stress disorder Post traumatic stress disorder (PTSD) is a severe form of anxiety disorder that manifests in individuals after experiencing a severely traumatic event. These events vary in form and may include those that are potentially life-threatening, or being a survivor in gross traumatic incidents. People with PTSD usually suffer from a combination of new behaviors typical of anxiety like insomnia, increased agitation, decreased concentration and difficulties in fulfilling the normal activities of daily living. Furthermore, some people affected with PTSD endure periods of re-experiencing the event through flashbacks and bad dreams that eventually affect their overall functioning in the society. Like many psychiatric conditions, the management of PTSD naturally involves a complicated scheme that targets psychosocial impact of the condition aside from the physical manifestations. In this paper, selected research articles are evaluated as to the current policy modifications in the assessment, diagnosis and treatment of PTSD. Literature Review The assessment of traumatic events that could potentiate the onset of PTSD can be easily overlooked in the clinical settings that could lead to under-diagnosis and mismanagement. The study by Peirce et al. (2009) evaluated the sensitivity of assessment tools in determining the presence and severity of traumatic experience as perceived by individuals. In particular, this study aimed to compare a behaviorally specific comprehensive multiple-item traumatic event measure with a single-item measure on their sensitivity in determining the relative risk of PTSD diagnosis. Method. Researchers utilized a counter-balanced design to compare two assessment tools: Traumatic Life Events Questionnaire (TLEQ) and single-question traumatic event assessment as indicated in a Structured Clinical Interview in the DSM- IV (SCID). These assessment tools were used in the clinical interview of 129 participants from the opioid-dependence treatment who were involved in the study. Results. The study generated remarkable differences in the efficiency and sensitivity of the two assessment tools. TLEQ reflected 9-fold higher rate of traumatic events as reported by the participants, compared with the SCID. This finding indicates that the TLEQ reveals a PTSD-risk at an increased accuracy. Statistically, the diagnosis of PTSD increased to 33% in TLEQ from 24% in SCID among the participants. In addition, PTSD diagnosis was established more in women than men in the sample population. Discussion. While this study involved only a specific group of participants with imbalanced ratio of men to women, the results have significant implications on the policy modifications of assessment of traumatic events that potentially lead to the diagnosis of PTSD. Furthermore, other factors like the experience and competence of the therapists involved in the assessment process need to be considered when considering policy changes. On the other hand, the diagnosis of PTSD should not be based only on the result of one assessment tool, but from the collective data obtained from physical assessment, perceived situational adaptations, history taking, and individual factors. The link between cannabis use and PTSD diagnosis has recently been the subject of researches by social scientists. In the research by Cougle et al. (2011), a clinically valid relationship between the two variables was proposed using a large sample population. Method. Specifically, this study involved adults from the United States who reported cannabis usage in the previous year. The sample population was noted to cover 5,625 adults. A survey was used for data collection. Results. Variables adjusted in the statistical analysis of data included sociodemographic variables, alcohol use disorders, and nicotine dependence. Consequently, research outcomes revealed a significant involvement of a lifetime history of cannabis usage or at least a daily usage in the past year in the diagnosis of PTSD. An increased lifetime risk of PTSD was noted in any past year cannabis use. Furthermore, the relative risk of the incidence of PTSD increased consistently even after adjustments in anxiety and mood disorders. Discussion. While this study is not the pioneer in PTSD research, the researchers utilized a large representative sample that could validate previous similar findings by other scientists. In addition, the results of this study provided important implications for the mental health professionals in the assessment and management of people diagnosed, or especially at high risk of developing PTSD in their lifetime. On the other hand, PTSD is more common in special population with frequent encounters of traumatic experience that potentiates the development of the condition. Research by Smith et al. (2011) studied how firefighters managed to cope up with the anxiety and mood disturbances resulting from traumatic fire incidents and other community disasters. Method. Researchers utilized the Mindfulness Awareness and Attention Scale (MAAS) to assess mindfulness of 124 urban firefighters. Measures of resilience included mindfulness, optimism, personal mastery, and social support. Other health measures were also completed by the participants, which included PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems. Control variables included measures of firefighter stress, number of calls, and years of experience. Hierarchical multiple regressions categorized dependent variables (health measures) with independent variables (demographic characteristics, firefighter variables, and resilience resources). Results. Research data analysis showed remarkable reduction in PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems with the mastery of mindfulness skills by the firefighters. Furthermore, social support, skills mastery, and number of years of experience also showed similar results. Conversely, individual factors as in firefighter stress increased the incidence rate of the dependent variables. Discussion. The results of this study provide important implications in the mental health professionals directly dealing with people with PTSD. While it is true that PTSD has been thoroughly studied in the general population, special population with increased vulnerability (as in firefighters) to develop the condition is not yet fully understood. Other important factors, not necessarily applicable with the general population, play significant role in the coping and prevention of PTSD. Generally, firefighters need to develop special skills in coping with traumatic events to maintain optimum functionality. Likewise, people under certain circumstances are more vulnerable to develop PTSD. Research by Norwood and Murphy (2011) aimed to explore the relationship of being a sexual abuse victim and the reporting incidence of PTSD. Specifically, the study hypothesized that sexual abuse would predict the diagnosis of PTSD, and that it is independent from other predictive factors such as physical assault and psychological abuse. Method. Researchers recruited 216 female partners to be subjects in the study. Individual reports and interviews were used as research tools in the study. Results. Out of the sample population, 64.1% did not report any sexual abuse, while 17.2% reported sexual coercion and only 18.7% reported being victims of sexual violence. Consequently, women who admitted having experienced either sexual coercion or violence had higher rates of PTSD compared to those who were not victims. While this data reflects the direct correlation between the two variables, multivariate analysis showed that sexual coercion and violence is not independent with other factors like physical and psychological abuse. Discussion. The results of this research have significant implications in the assessment of the possible incidence of PTSD among sexually abused women. In particular, assessment of abused women should cover numerous biopsychosocial aspects of the sexual trauma, rather than isolating the physical and psychological experience. Meanwhile, the continuous improvement in PTSD management has saturated the literature of the mental health profession in the recent decade. However, certain factors inhibit the health care facilities to adapt to newer evidence-based practices as proposed by researchers and scientists. The study by Couineau and Forbes (2011) sought to identify the factors that prevent the mental health facilities to adapt to newer standards and protocols of care approved internationally. Furthermore, this study also aimed to facilitate ways so that these facilities eventually conform to evidence-based practices in the promotion of mental health and treatment of psychiatric conditions, especially PTSD. Method. A survey research design was utilized to attain the primary objective of this study. 6 community trauma services were involved in the study. Training and support strategies were the treatment variables. Evaluation of the intervention was performed using self-report surveys and audit of reports from clinicians. Results. The consolidation of data revealed that lack of skills and confidence significantly reduced the efficiency of clinicians in the management of trauma that could potentially result to the diagnosis of PTSD. Furthermore, these same factors also inhibit the facilities in conforming to the internationally accepted evidence-based practices for PTSD. Discussion. While there is a rapid increase in the professional literature about PTSD, this does not directly translate that the frontline mental health facilities adapt to these new changes. The results of this study highlighted the pressing need for training to increase the confidence and competency of clinicians and improve the management of trauma as well as PTSD. Conclusions and Recommendations The mysteries of the posttraumatic stress disorder have been unraveled extensively in the recent decades. Scientists and social researchers continue to discover the relationship of numerous factors arising from the unique individualized context of people vulnerable of experiencing the signs and symptoms of the psychiatric condition. Research findings from different sub-population resulted in more efficient methods of management of PTSD. However, limitations in the health care facilities and challenges in the competencies of mental health professionals still leave major disadvantages in the implementation of these research findings. Thus, the importance of adequate training of personnel should not be overlooked in the clinical setting. References Cougle, J.R., Bonn-Miller, M.O., Vujanovic, A.A., Zvolensky, M.J. & Hawkins, K.A. (2011). Posttraumatic stress disorder and cannabis use in a nationally representative sample. Psychology of Addictive Behaviors, 25(3), pp. 554- 558. doi: 10.1037/a0023076 Couineau, A.L., & Forbes, D. (2011). Using predictive models of behavior change to promote evidence-based treatment for PTSD. Psychological Trauma: Theory, Research, Practice, and Policy, 3(3), pp. 266. 275. doi: 10.1037/a0024980 Norwood, A., & Murphy, C. (2011). What forms of abuse correlate with PTSD symptoms in partners of men being treated for intimate partner violence? Psychological Trauma: Theory, Research, Practice, and Policy. doi: 10.1037/a0025232 Peirce, J.M., Burke, C.K., Stoller, K.B., Neufeld, K.J., & Brooner, R.K. (2009). Assessing traumatic event exposure: Comparing the Traumatic Life Events Questionnaire to the Structured Clinical Interview for DSM-IV. Psychological Assessment, 21(2), pp. 210- 218. doi: 10.1037/a0015578 Smith, B.W., Ortiz, J.A. Steffen, L.E., Tooley, E.M., Wiggins, K.T., Yeater, E.A., Montoya, J.D., & Bernard, M.L. (2011). Mindfulness is associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems in urban firefighters. Journal of Consulting and Clinical Psychology, 79(5), pp. 613- 617. doi: 10.1037/a0025189 Read More