Prevalence Battle Fatigue among Military Personnel - Research Proposal Example

? Prevalence of Post-traumatic stress disorder (PTSD) among military personnel Charles Cephas of the Rockies There are many causes of Post-traumatic stress disorder (PTSD). PTSD effects are devastating and can have serious consequences in the life of the affected person, family members and the society at large. This study aims at investigating how biological reactions result in acute and chronic levels of PTSD and effective ways of treating PTSD for the military personnel and their families. The study will therefore test the hypothesis that a Soldier that has returned from war and has been treated for being diagnosed with PTSD can lead a long a prosperous life if treatment is sought and continued for as long as needed. To achieve this, the study will utilise descriptive, cross-sectional survey design. In order to get the insight of the case at hand, the researcher needs to obtain first hand information from selected respondents. In this regard, it will be critical to utilise questionnaires and interviews. Introduction Post-traumatic stress disorder (PTSD) is believed to develop as a result of a terrible frightening experience that threatens victim’s safety (Monika, 2007). As a result of such an occurrence, the victim feels helpless. To some extent, the victims tend to keep away from places, populace, or other things that refreshes their memories on an incident that happened before (Richert, 2007). This illness is also associated with anxiety disorder where the victim is always anxious of terrible occurrences. This study is paramount in assessing how PTSD affects family members of the military personnel (Laura 2011). In essence, it is clear that the effects of the disorder extend to the immediate family members (Ford, 2009). In this regard, it is imperative to have a comprehensive study carried out on the effects of the disorder so as to develop ways of dealing with the disorder. As the wars in the 21st Century bring different levels of fighting, the results for casualties are more devastating. Although the deaths from previous wars are not as high, the lifelong damaging effects of these wars are more severe and life threatening i.e. loss of limb and severe trauma to the brain. Research Questions I. How do biological reactions result in acute and chronic levels of PTSD? II. What are the key differences in the biological response to ordinary life stress and stress from a traumatic incident? III. How soundly are practitioners trained to handle PTSD and their patients? Hypothesis Due to the sternness of surviving with PTSD, I believe that PTSD has some shocking potentials to prompt depression in war veterans. This may lead to suicidal thoughts and self-inflicted death." Soldiers that are returning from the war that are not seeking treatment for PTSD are more likely to suffer the ill effects of the disease. I have concluded that a Soldier that has returned from war and has been treated for being diagnosed with PTSD can lead a long a prosperous life if treatment is sought and continued for as long as needed. Problem statement Traumatic experiences are fairly common among the world’s general population. In the epidemiologic reviews, the oxford journal asserts that more than two-thirds of the general population may experience noteworthy distressing incident at some point in their lives. Countries around the globe have been to different kinds of events that cause trauma. These are such as terrorism, child abuse, and trafficking, compulsory relocation, violence, and conflicts, mass genocides, and other killings, natural disasters like hurricanes, floods, and earthquakes. Following exposure to traumatic disasters and events, people develop a psychological disorder, which is clinically referred to as the post-traumatic stress (PTSD) disorder. In the previous three decades, PTSD has gotten the attention of mental health experts and the public at large. PTSD was initially brought into the DSM-III (Diagnostic and Statistical Manual of Mental Disorders) in 1980 (Rosen & Frueh, 2010). The study of PTSD is essential in helping clinicians conceptualize the reactions of patients to horrific and life threatening experiences. In addition, PTSD study also helps mental health experts assist patients with an assortment of stress issues in a better way. The study of PTSD is beneficial in helping the public understands on ways to adjust in the aftermath of trauma because stressful events are barely unavoidable in the contemporary world. It, therefore, becomes essential to study PTSD in a bid to deal with the ever-increasing cases and events of trauma around the globe. Literature review on Post Traumatic Stress Syndrome Currently, diagnostic statistical manual of mental disorders IV (DSM IV) is used for PTSD diagnosis. The criterion for diagnosis depends on the following factors. One, a patient ought to have had direct individual experience of an occurrence that entails actual or threatened fatality or severe injury, or other hazard to one’s physical veracity. Second, diagnosis depends on an individual witnessing an event that involves casualty and injury, or a peril to physical integrity of another person. Learning about unanticipated violent death or severe harm, or danger of death or injury encountered by a family member or a close friend also qualifies for PTSD diagnosis (Yehuda, 2002). PTSD is characterized by three main symptoms; intrusive/re-experiencing, avoidance, and arousal. The entire diagnosis using the DSM-IV criteria necessitates the incidence of at least one re-experiencing indicator, three avoidance symptoms, and two arousal signs. Intrusive events are the unwanted recollections of the event that takes the form of nightmares and distressing images. Avoidance signs are, such as efforts to avoid reminders of the incident including thoughts associated with the incident. Arousal indicators take the form of physiological expressions like irritability, hypervigilance, and restlessness. Immediate experience of the above reactions following a traumatic event is taken as normal rejoinder. If symptoms continue up to three months, acute diagnosis of PTSD can be made; and signs exceeding three months are taken as chronic. Traumatized persons may be diagnosed with acute stress disorder (ASD) in the first month after a disturbing experience. ASD signs include PTSD elements and awareness reduction dissociative amnesia and detachment. Though ASD is not always followed by PTSD, it is connected to enhanced risk of PTSD (Lunt, & Hartley, 2004). Both personal characteristics and the incident itself determine the biological and physiological reaction to a distressing event. The first response may be influenced by a person’s subjective interpretation of the event that in turn influenced by the individual’s past experiences and other risk factors. Knowledge of a distressing incident challenges an individual’s feeling of safety, resulting to feelings of powerlessness and vulnerability. Recovery from the incident entails facing human helplessness in a manner that fosters advancement of resilience (Neria, Nandi & Galea, 2007). A biologic reaction after the occurrence of a traumatic event can bring about a condition of fear that impedes with the restoration of feelings of safety. Avoidance lessens the chances of extinguishing fear reactions and hinders the advancement of efficient strategies for coping leading to interpersonal, social and/or occupational disturbance. Some people recover from stressful incidents while others do not as a result of biological changes. Patients with persistent PTSD have high levels of circulating neropinephrine and high ?2-adrenergic reactivity that result in somatic signs of PTSD. These biological responses do not resemble those involving other kinds of stress. For examples, some patients exhibit lesser than normal cortisol levels, even years following a distressing incident. PTSD prevalence varies across different populations and can change over people, place, and time. For instance, prevalence of PTSD documented after natural disasters is usually lower than the amounts documented after man-made/technological disasters. Higher PTSD prevalence has been observed among people at the epicenter of a natural disaster as compared to those who are100 km away (Galea, Nandi & Vlahov, 2004). In addition, biological reactions result in acute and chronic levels of PTSD. Several modes of treatment and medication are available for diagnosis of PTSD. They include counseling and psychotherapy, medication, and referral. Counseling is a noteworthy element of treatment of PTSD victims that entails education provision and support from primary caregivers. Educating stress victims helps them understand the nature of their state of affairs and the recovery process. This involvement can help create a therapeutic alliance and help victims understand the need for therapy. Psychotherapy entails therapy through talking that entails talking to a mental health professional. Talk therapy takes six to 12 weeks, but it can take more time, depending on the patient as people recover faster than others. Support from relatives and friends have been shown to be a significant aspect of therapy. Several types of psychotherapies target direct sign of PTSD while others focus on family, social and work related problems. Different kinds of therapies may be combined depending on each patients needs. Cognitive Behavioral Therapy (CBT) is the most significant in PTSD treatment. CBT has several elements: exposure therapy helps trauma victims face and control their fear by exposing victims to the trauma they experience in a safe manner. Therapists use this model to help victims handle their feelings. Cognitive restructuring therapy helps stress victims make sense of the “bad” memories. The therapist aids people suffering from PTSD examine at what transpired during the incident in a realistic approach. Stress inoculation training therapy seeks to reduce PTSD signs by teaching the victim on ways to reduce anxiety (Jongsma & Bruce, 2011). Medication helps victims eradicate signs of PTSD and improve the entire physiological and psychological functioning. Randomized trials on tricyclic antidepressants and selective serotonin-reuptake inhibitors demonstrate improvement on individuals suffering from PTSD. Sertraline (Zoloft) and paroxetine (Paxil) have been approved for PTSD medication by the U.S. food and drug administration. Medication by use of antidepressants results in side effects such as headache, nausea, drowsiness or sleeplessness, agitation, and sexual problems like reduced sex drive. These effects fade away within a few days, failure to which the victim should report to a physician immediately. Primary care doctors can opt to refer trauma victims for a particular treatment if initial interventions have not been fruitful or where medication results in side effects. PTSD victims may experience severe psychiatric problems, suicidal thoughts, drug addiction problems that necessitate specialized care (Jongsma & Bruce, 2011). Rationale for existing studies In her research titled combat veterans diagnosed with posttraumatic stress disorder: the effect on their children: a phenomological stud, Frenz looks at the effects of psychological effects of combat soldiers on their children. She takes a phonological approach to study the subject. The author studies18 subjects and looks at how they were affected by their parents being in military combat. Frenz looks at the data associated with the children having their fathers being in military combat. She uses the subjects as the case studies to understand the phenomena and at the same time tries to understand the various ways in which these subjects were affected. On the other hand, Wind and Weymouth (2004), in their article review of studies of healing touch, use the grounded approach theory to investigate the effects of using healing tough as a way to treat Post Traumatic Stress Syndrome. The unifying factor between these two studies is the fact that they both prefer to have a direct approach to the issue under investigation. However, Frenz (2007) seems to have had a research based on bias due to a number of reasons. First, her need to research the subject came as a result of her childhood as a daughter of a combat soldier. Wind and Weymouth (2004), on the other hand, look at the problem from a blind angle of view and their study is guided by exploring the subjects. At the same time, unlike Frenz who uses human subjects to study her topic, Wind and Weymouth (2004) used other studies to investigate the subject they were using. Their study, unlike Frenz’s is a study of other studies. This means that their study was like a comprehensive literature review. However, instead f just carrying a comprehensive literature review, they use the statistics about the findings of each of the studies to come to the conclusion. PTSD (Post Traumatic Stress Syndrome) is a very important area of study and there is a need to understand the issues that are pertinent to it. One of the most controversial factors about Post Traumatic Stress Syndrome is the fact that many patients may are diagnosed with the wrong syndrome and this leads to the disorders getting worse (Preston & Keane, 2004). As Whitfield (2004) says, it is common knowledge and there is a need to make sure that better diagnosis methodologies are used in order to guarantee the health of the patients and make sure that patients are able to regain their health as soon as possible. With regard to most psychological and mental disorders, there can always be a layer of issues that may be affecting the patients (David, 1992). With this kind of a situation it is always easier to make sure that all the possible issues are taken care of. For instance, how often is it possible that some patients are diagnosed with the wrong psychological disorder? Do most patients who have psychological disorders get diagnosed with the wrong disorder? And how can a therapist increase his or her ability to get the right diagnosis to a patient? To be in a position to answer this question, it will be important to use the Grounded Theory approach to determine how often it is that a patient with a psychological or mental disorder gets diagnosed with the right disorder. This will be achieved by looking at the patients with psychological disorders who have been misdiagnosed and then try to loot at the characteristics that may have caused them to be misdiagnosed. This study will help in understanding what kinds of patients with a psychological disorder are most likely to be misdiagnosed. The objective of this research is to aid in reducing the number of psychological disorder patients who get misdiagnosed and help therapists to be more equipped in handling their patients. Research gap There is a potential overlap involving signs of PTSD and those of depression and other anxiety disorders. Practitioners may be hesitant to enquire information that may be distressing, secretive, or shameful from their patients. On their part, patients may also avoid mentioning such information to the practitioner without persistent probing. This creates a treatment barrier and may result in missed diagnosis or diagnosis for the wrong problem. Figure 1- Conceptual Framework Independent Variables Dependent Variable Methodology Research design The current study will be conducted using descriptive, cross-sectional survey design. The design will encompass collecting data on a sample of respondents who will be sampled to represent PTSD victims and Psychotherapist. This will encompass collecting data at one point in time from a sample selected, which will be used to represent larger populations. This design is appropriate in this study because it will not deal with a single case, but rather multiple cases sampled from the targeted population. Data collection instruments In the efforts to acquire empirical evidence in light with gaining insights about the need to manage PTSD, it is indispensable for the study to gather first hand information, which will be accessed by the use of questionnaires and interviews. Reliability and validity Reliability of the instruments will be estimated by a way of testing and re-testing. This can be achieved through piloting of the instruments to be used in the study. In regard to ascertaining the validity of the instruments, it will be indispensable for the researcher to seek assistance from the supervisor in the effort to assess the relevance of the content used in the instruments to be utilised in the study. Target Population This study will primarily target military personnel who have been diagnosed with signs and symptoms of post-traumatic stress syndrome at Kandahar Air Force base. Being in a deployed environment, this type of study has an abundance of test subjects openly willing to participate in what they describe as something that will hopefully help them one day. During the sessions that I have attended, I have witnessed Soldiers that have amputations, mental scarring and severe affects of multiple concussions. My audience consists of Soldiers that have been diagnosed with PTSD and also other similar symptoms such as Inability to sleep, deep depression, and constant nightmares. Sample Size The sample size for this study is around twelve to fifteen Soldiers per session. The numbers change every session due to the busy rotation of Soldiers coming in and out of the battlefield. Some of the Soldiers are admitted to the wounded warrior’s camp by way of doctor’s orders due to a diagnosis, volunteer bases, or as medical holds due to inability to diagnose. This type of crown is perfect for my quantitative research because of the variety of similar Soldiers that participate. I sometimes identify some of the Soldiers by the job title or their rank to try and get certain train of thoughts based from what they do. Larger samples are more likely to yield data that accurately reflect the true population value (Cozby & Bates, 2012). I am limited to the size of the sessions because I cannot control the influx of the Soldiers experiencing this trauma. Back in the United States I would travel from VA hospital to VA hospital to get a wider variety of Soldiers diagnosed with this ailment. Place of Sample The samples for this research will come from the wounded warrior’s camp in KAF (Kandahar Air Base). This airbase is among of the largest army bases in Afghanistan and it has the capabilities of any large hospital in this type of an environment. There are profession doctors on twenty-four hour standby to assist and handle any situation that arises. This is another benefit to help me in my studies and understand the rawest emotions associated with this research. Defined Population Because the study is geared towards Soldiers that are experiencing PTSD in a wartime environment, the sample research is a representative of the defined population. During this war there have been more Soldiers that continue to suffer from PTSD more and more throughout the years. The Soldiers are suffering more and more from depression and the side effects of PTSD. Drugs are being abused and Soldiers are acting in manners detrimental to their careers simply because of the aftereffects of the trauma caused from being in this type of environment. Groups The amount of groups will determine the size of the Soldiers attending the session for that day. The Soldiers will be separated by rank and position on days when there are enough subjects to accomplish that task. On other days when the Soldier count is less than desired, grouping the Soldiers by way of rank and job title. This method of grouping is used to group together familiarity. Most of the Soldiers are injured in pairs or more so their job title may be the same and they can provide a likeness story wise. This in turn acts as a conversation identifier. Many of the Soldiers can relate to what the other is talking about and in turn can tell his own story. Analysis of the differe3nt accounts by the soldiers will be done on the basis of similarity of different accounts given. Obviously, the subject matter that will be explained by the majority of the soldiers will amount to conclusions about the effects of PTSD on soldiers. Sampling Method The sampling method that I will use for my research is purposive sampling. The purpose is to obtain a sample of people who meet some predetermined criterion (Cozby & Bates, 2012). This sampling method first enables me to single out a particular group of people and ask them questions pertaining to the research. Videotaping and recording all activities will also be included in the process of evaluating this audience. This will enable me to get raw emotions out of the audience and also enable missed research clues missed by the naked eye. All of these participants will have been diagnosed with PTSD or similar ailments and must have received this ailment due to the stressors of wartime. This sampling method enables me to pinpoint an audience that all share a common set of stressors. Other sampling methods such as quota sampling, sampling frame, and convenience sampling do not particularly cater to my method of sampling therefore will not be effective while gathering pertinent information. Data analysis In a bid to analyse the data effectively, there will be a need to edit, code similar themes, and classify the data. These processes will aim at detecting errors and omissions and reduce data into homogeneous groups that will help in getting meaningful relationships. Descriptive and inferential analysis will be employed for measurement and determination of the relationship that exists among the variables. In matters pertaining ethical considerations, according to Gregory 2003, the researcher needs to be careful in order to avoid use of inflammatory words and other conducts that might cause any harm to participants. They should avoid asking irrelevant questions. In addition, researcher will assure respondents of confidentiality, anonymity, and avoidance of deception during and after the research. This is very crucial especially in the current study, which will articulate on issues of health, which according to many people is a private matter. Ethical consideration In any research, the researcher is required to exercise highest level of ethical protocol and consideration when carrying out the study. In this particular study, the researcher will avoid using irreverent or embarrassing questions to the respondents in order to avoid causing physical and psychological harm. In addition, confidentiality and anonymity will also be assured to the respondents. Additionally, the researcher will first seek permission from relevant authorities before carrying out the study. References: Gregory, I., 2003, Ethics in research. Continuum International Publishing Group, London. Ford, J. (2009). Posttraumatic stress disorder: scientific and professional dimensions. Amsterdam; Boston: Elsevier/Academic Press. Sabina, R. (2008). Occurence of Symptoms of PTSD and Complex PTSD in Homeless Persons and Survivors of Domestic Violence. ProQuest. Richert, K. (2007). Pediatric Posttraumatic Stress Disorder and the Development of the Prefrontal Cortex. ProQuest. Monika, F. (2007). Combat veterans diagnosed with posttraumatic stress disorder: the effect on their children: a phenomological study. Retrieved from: http://www.veteransandfamilies.citymax.com/f/Combat_Veterans_with_PTSD_and_the_Effects_on_Their_Children_July_2007.pdf Laura M. (2011). Knowledge and acknowledgement of posttraumatic stress disorder and effects on military couples. Retrieved from http://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1096&context=gradschool_theses Galea, S., Nandi, A., & Vlahov, D. (2004). The epidemiology of post traumatic stress disorder after disasters. Oxford journal of medicine: epidemiologic reviews, 27, 1: 78-91. Jongsma, A.E & Bruce, T.J. (2011). Evidence-Based Treatment Planning for Posttraumatic Stress Disorder, DVD Companion Workbook. New Jersey: John Wiley & Sons Press. Lunt, J., & Hartley, R. (2004). Literature review of post traumatic stress disorder amongst rail workers. Retrieved on 11 March 2013 from: http://www.hse.gov.uk/research/hsl_pdf/2004/hsl0416.pdf. Neria, Y, Nandi, A., & Galea, S (2008). Post-traumatic stress disorder following disasters: a systematic review. Psychological medicine, 38, 1: 467-480. Rosen, M.G., & Frueh, C. (2010). Clinician's Guide to Posttraumatic Stress Disorder. New Jersey: John Wiley & Sons Press. Yehuda, R. (2002). Post traumatic stress disorder. The new England journal of medicine, 346, 1: 108-114. Gregory, I., 2003, Ethics in research. Continuum International Publishing Group, London. Ford, J. (2009). Posttraumatic stress disorder: scientific and professional dimensions. Amsterdam; Boston: Elsevier/Academic Press. Sabina, R. (2008). Occurence of Symptoms of PTSD and Complex PTSD in Homeless Persons and Survivors of Domestic Violence. ProQuest. Richert, K. (2007). Pediatric Posttraumatic Stress Disorder and the Development of the Prefrontal Cortex. ProQuest. Monika, F. (2007). Combat veterans diagnosed with posttraumatic stress disorder: the effect on their children: a phenomological study. Retrieved from: http://www.veteransandfamilies.citymax.com/f/Combat_Veterans_with_PTSD_and_the_Effects_on_Their_Children_July_2007.pdf Laura M. (2011). Knowledge and acknowledgement of posttraumatic stress disorder and effects on military couples. Retrieved from http://uknowledge.uky.edu/cgi/viewcontent.cgi?article=1096&context=gradschool_theses &sei-redir=1&referer=http%3A%2F%2Fwww.google.co.ke%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3DPost%2BTraumatic%2BStress%2BSyndrome%3A%2Bdissertation%26source%3Dweb%26cd%3D2%26cad%3Drja%26ved%3D0CDoQFjAB%26url%3Dhttp%253A%252F%252Fuknowledge.uky.edu%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1096%2526context%253Dgradschool_theses%26ei%3DZ43-ULD8CZOGhQeLioHIBA%26usg%3DAFQjCNFBf3ZTwWUqtj5VwHNe-JRLMr_K1w%26bvm%3Dbv.41248874%2Cd.d2k#search=%22Post%20Traumatic%20Stress%20Syndrome%3A%20dissertation%22 Frenz, M. (2007). Combat Veterans Diagnosed With Posttraumatic Stress Disorder: The Effect On Their Children: A Phenomological Study. Phoenix: Frenz. Preston, P. K. (2004). Assessing Psychological Trauma and PTSD. New York, NY: Guilford Press. W.F., D. (1992). Treating Ptsd: Cognitive-Behavioral Strategies: Treatment Manuals for Practitioners. New York, NY: Guilford Press. Whitfield, C. L. (2004). The Truth About Mental Illness: Choices for Healing. New York, NY: HCI. Wind, D. &. (2004). Review of Studies of Healing Touch. JOURNAL OF NURSING SCHOLARSHIP , 1-8. Cozby, P., & Bates, S. (2012). Methods in behavioral research (11th ed). New York, NY: McGraw-Hill. Appendix Survey on PTSD The survey will be administered through questionnaires and face to face interviews. Some of the questionnaires will be sent through email to respondents who are in far regions. They are expected to answer and return them via email within seven days. Others will be administered physically. Face to face interviews will be conducted using questions set forth in the questionnaire. Section A contains questions that require a tick to indicate the response. Section B requires explanation whilst Section C has questions with a rating of 1-5 where 5 – Strongly agree 4-agree 3-neutral 2-disagree 1-Strongly disagree These responses will be evaluated on a Likert scale where SPSS package will be used for evaluation. Survey I am a student’s undertaking a degree in psychology at the university of ………………………………………………… I am expected to undertake a research study as part of the necessities for the award of the degree. I am doing a study on post traumatic stress disorder motor drivers. This survey questionnaire is meant to gather information that will be useful for completing the project. Information gathered from this survey will be accorded confidentiality and will be used for academic purposes only. As one of the respondents, I kindly request you, to provide the data by answering the questions to your utmost knowledge. Your response will be highly appreciated. Section A General information Please put a tick in the box in the respective response 1. Age 21-30 years 31-40 years 41-50 years 50 years and above 2. Gender Male Female 3. Employment status Personal driver Public service vehicle driver Company driver Taxi driver Other (specify)………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………… 4. Highest academic level obtained? Primary Secondary Diploma Degree Others (specify)………………………………………………………………….. …………………………………………………………………………………… Section B 5. How many years experience do you have in motor driving? 6. Have you ever encountered a motor accident? How did it arise………………………………………………………………. 7. What is the magnitude of a distressing accident you have ever encountered? 8. Did the accident affect your operations as a driver? Yes No If yes, how………………………………………………………………………………….. ……………………………………………………………………………………………… 9. How should drivers address their fears of future accidents?........................................... …………………………………………………………………………………………….. Section C 10. Drivers persistently experience intrusive memories and thoughts of a previous accident? 1-strongly agree 2-agree 3- neutral 4-disagree 5- Strongly disagree 11. Drivers persistently avoid thoughts, feelings and activities associated with a past accident? 1-strongly agree 2-agree 3- neutral 4-disagree 5- Strongly disagree 12. Drivers may display avoidance to accidents by shutting down emotionally such as difficulty in expressing their feelings and feeling distant from people? 1-strongly agree 2-agree 3- neutral 4-disagree 5- Strongly disagree 13. Drivers exposed to crashes/accidents may suffer from constant anxiety and heightened physical tension? 1-strongly agree 2-agree 3- neutral 4-disagree 5- Strongly disagree 14. In most instances, involvement in accidents may cause personal distress and impede job performance? 1-strongly agree 2-agree 3- neutral 4-disagree 5- Strongly disagree If the answer is 1 and 2 above, how do crashes affect job performance and relatively how long does this take…………………………………………………………………………………… …………………………………………………………………………………………………. 15. Drivers who had depression in the past have a higher risk of developing a stress disorder after experiencing an accident 1-strongly agree 2-agree 3- neutral 4-disagree 5- Strongly disagree Read More