PTSD: Physical, Mental, and Spiritual Dimensions - Research Paper Example

? PTSD: Physical, Mental, and Spiritual Dimensions­­­ This paper will summarize the symptoms, causes, treatments and prognosis for post-traumatic stress disorder (PTSD), as well as co-morbidity factors typically seen with this disorder. Because the cause of any disorder can be a complex matter, attention will be given to risk and vulnerability factors influencing the development of the disorder, its treatment, diagnosis and prognosis. The paper will look more specifically at PTSD among combat veterans, considering co-morbidity of traumatic brain injury and protective effects of religiosity. Post-traumatic stress disorder has various indications. The definitive consideration, based on the research, is whether or not symptoms follow a traumatic event in which fear, horror, or helplessness were experienced, and resulted in clusters of typical symptoms that are significantly upsetting and/or interfering with daily functioning for at least one month or longer (MediResource Inc., 2013). Military post-deployment health assessment was found to identify 13.8% of male combat soldiers as having possible PTSD and found that symptoms were not necessarily immediate but usually activate within one year of the traumatic event (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012). PTSD statistics are found to be twice as high for females (MediResource Inc., 2013). The major categories of those symptoms include recurring and intrusive memories of a traumatic experience or experiences; introversion and avoidance of anything that might trigger the memories; and hyper-arousal (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012; MediResource Inc., 2013). Intrusive memories might come in the form of flashbacks, in which the person with PTSD actually relives the traumatic situation (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012). For example, a soldier, traumatized from combat, might be playing ball with his children and might suddenly think he is being shot at by an enemy. He may not see the children anymore, but rather the earlier memory of danger and violence is inappropriately superimposed on his current experience. Intrusive memories might also result in quiet staring, or being lost in thought (Tran, Kuhn, Walser, & Drescjer, 2012). Introversion and avoidance might be reflected in social withdrawal, insomnia, avoidance of conversation, feeling like more of an observer than a participant (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012). The person may seem hesitant to renew relationships (Tran, Kuhn, Walser, & Drescjer, 2012). They may also turn to alcohol and drugs as a way to withdraw into themselves or mask the bad feelings (MediResource Inc., 2013). Hyper-arousal is typically seen in the startle reflex and in the feeling that something bad is about to happen, even without objective indications (MediResource Inc., 2013). Research has found that people with a history of trauma have lower mean cortisol levels. Cortisol is a hormone that is released to help the body cope with stress. However, responding to trauma reduces the body’s blood cortisol level after subsequent trauma (Resnick, Yehuda, Pitman, & Foy, 1995). It is an indication that the body is not reacting in a natural way anymore. In diagnosing PTSD in soldiers with combat experience, post-deployment neurobehavioral and physical symptoms are considered. Neurobehavioral symptoms include such things as irritability, insomnia, inability to concentrate, forgetfulness, indecision, while physical symptoms include such things as headaches, loss of hearing or vision, weakness, numbness (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012). However, PTSD can be difficult to diagnose because of the various configuration of symptoms, the often delayed occurrence of symptoms, inadequate self-reports, and because the symptoms overlap with blast-induced, mild TBI (traumatic brain injury) (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012). Initially, PTSD was understood to be caused by combat trauma. However, currently it is understood to be a possible outcome of other types of trauma: accidents, rape or sexual abuse, natural disasters, etc (MediResource Inc., 2013). PTSD can occur from the trauma of witnessing violence or an accident or natural disaster, seeing dead bodies. It can occur from facing or witnessing traumatic events, but is not an inevitable outcome (MediResource Inc., 2013). There are various risk factors that increase vulnerability, and there are protective factors that decrease vulnerability. Risk factors include female gender (MediResource Inc., 2013), being a child (MediResource Inc., 2013), repetitive or multiple traumas or ongoing trauma (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012), lack of appropriate, professional intervention and a pre-existing anxiety disorder (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012), low religiosity or a negative concept of God as being wrathful, punitive, uncaring (Tran, Kuhn, Walser, & Drescjer, 2012). Protective factors include early and appropriate professional intervention, especially directly addressing symptoms rather than symptom categories (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012), isolated trauma incident, strong mental well-being at the time of event occurrence, high religiosity and a positive concept of God as being forgiving, caring, benevolent, for example (Tran, Kuhn, Walser, & Drescjer, 2012). Complicating the diagnosis, treatment and prognosis of PTSD are co-morbid disorders. TBI, for example, has various symptoms which overlap with PTSD, confusing the situation (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012). Depression is a common co-morbid disorder, especially with combat veterans, among whom 80% develop depression, along with PTSD (Tran, Kuhn, Walser, & Drescjer, 2012). Trauma can cause a spiritual wound which may redefine faith and go untreated because psychologists are not usually encouraged to identify or process spiritual matters with clients, and because the person may consider it to be a very private development or be embarrassed to articulate it (Tran, Kuhn, Walser, & Drescjer, 2012). The best psychological treatment for PTSD has been found to be cognitive-behavioral therapy, in which the thoughts and assumptions related to the intrusive memories and behavioral responses are carefully examined, and new strategies of thought and response are activated (MediResource Inc., 2013). For example, a person who was kidnapped and held hostage in a large, dark house, may suffer intrusive memories each time a large, dark house is encountered. The underlying assumption might be found to be that all large, dark houses pose a threat. When the memories begin to intrude, the person, understanding the underlying thought pattern, might instead argue internally that this house is not “that” house, or might reconnect that sort of house with a funny television show or movie, like ”The Adams Family” or “The Munsters”. This new thought can invite a more positive response. Desensitization occurs when the traumatic experience is revisited in a safer context (MediResource Inc., 2013). Medication can also be a useful intervention for PTSD. These typically include serotonin reuptake inhibitor (SSRIs), anti-depressants, and sometimes antipsychotics and mood stabilizers (MediResource Inc., 2013). Prognosis is usually very good with therapeutic and pharmacological intervention (MediResource Inc., 2013), and preferably with appropriate spiritual intervention (Tran, Kuhn, Walser, & Drescjer, 2012), although PTSD symptoms will often reduce or even disappear over time, even without professional intervention (MediResource Inc., 2013). Prognosis is less hopeful when the PTSD has become chronic, is co-morbid with depression, pre-existing anxiety disorders, or with substance abuse (MediResource Inc., 2013), when the person has an unidentified condition such as TMI (Macera, Aealis, MacGregor, Rauh, & Galarneau, 2012), when the person’s lifestyle or life circumstances continue to present traumatic experiences (Resnick, Yehuda, Pitman, & Foy, 1995), and when the person has low religiosity or a negative God concept (Tran, Kuhn, Walser, & Drescjer, 2012). This paper has provided a summary of the defining features of PTSD; its physical, mental, and spiritual dimensions; risk and protective factors; symptoms; co-morbidity; psychological and pharmacological treatment; and prognosis. The paper has given specific emphasis to research on PTSD in combat veterans, particularly those with TBI, and considered the effects of religiosity. Further research is needed on PTSD prevention factors, gender differences, and spiritual dimensions. References Macera, c. a., Aealis, H. J., MacGregor, A. J., Rauh, M. J., & Galarneau, M. R. (2012). Postdeployment symptom changes and traumatic brain injury and or posttraumatic stress disorder in men. JRRD , 49(80);1197-1208. MediResource Inc. (2013). PTSD. Retrieved March 2, 2013, from Canada.com: http://bodyand health.canada.com/condition_info_details.asp?dsease_id=194i Resnick, H. S., Yehuda, R., Pitman, R. K., & Foy, D. W. (1995). Effect of previous trauma on acute plasma cortisol level following rape. The American Journal of Psychiatry , 152(11): 1675-1677. Tran, C. T., Kuhn, E., Walser, R. D., & Drescjer, K. D. (2012). The relationship between religiosity, PTSD, and depressive symptoms in veterans in PTSD residential treatment. Journal of Psychology & Theology , 40(4): 313-322. Read More