Risk Factors for Post Traumatic Stress Disorder - Coursework Example

Running head: POST TRAUMATIC STRESS DISORDER On Post Traumatic Stress Disorder's Risk Factors INTRODUCTION Post traumatic stressdisorder is characterized as a severe reaction to trauma. According to Petty (2000) "several large-scale national surveys showed that this is one of the most common (if not the most common) psychiatric disorders in the USA today". To be fully diagnosed with this disorder, one must have symptoms in each of the symptom groups clustered into the intrusive, avoidance and hyper arousal symptoms. Intrusive symptoms refer to "intrusive thoughts, nightmares, flashbacks and a physical or psychological reaction to reminders of the trauma" (Petty, 2000) Avoidance symptoms are withdrawal, decreasing pleasure in normal activities, difficulty in expressing emotions, negative thoughts towards the future and avoidance of people, places and events that are reminders of the traumatic experience. Furthermore, hyper arousal symptoms refer to being skittish, hyper vigilance, irritability, anger outbursts and difficulty in sleeping and relaxing. This life affecting condition is distressing, weakening and a big hindrance for a person to achieve his outmost capacity. Generally, treatment for this disorder is medication, cognitive behavioral therapy or the combination of both. Traumas are unforeseen disturbing incidents that bring forth different reactions from people. While different people have various mechanisms in coping with traumatic experiences, some people do tend to develop the post-traumatic stress disorder due to the intense emotional impact of traumas. There is however various possible risk factors that contribute to the development of post traumatic stress disorder. Numerous studies are emerging to learn more of these existing risk factors. This paper then is a discussion of some recent studies done on gender, socio-economic status and preexisting psychological conditions as risk factors for developing post traumatic stress disorder. Gender It is clear that the men and women of a general population do differ not only in physiological and biological aspects but in a social level as well. Emotional and psychological vulnerability differ because men and women react to experiences in clearly much different ways. In a study done by Davidson, Kigamwa, Nicholls, Njenga and Nyamai (2004), a group of people were studied within three months after a terrorist attack. These people were first hand witnesses to "the bombing of the US embassy in Nairobi, Kenya, on a busy Friday morning in August 1998". The bombing resulted to 220 dead people and injuries to thousands of people. The 2, 627 respondents to the study were mostly made up of educated and professional individuals. Of the people included in the study, 47% consisted of women and more than half of the women were married and pregnant at the time of the bombing. The study established that there were 35% of the population sample that coincided with post traumatic stress disorder symptoms after the test results was summarized. Factors related with the analysis were associated primarily with the subjects having the female gender along with unmarried status and less education. For post traumatic stress disorder, gender should be regarded with more attention and understanding because according to Gavranidou and Rosner's (2003) findings in their review of recent studies, "men experience traumatic events more often, women and men differ in the type of traumatic experiences , and women more often develop post traumatic stress disorder after the experience of a traumatic event". Men and women differ in the type of traumatic experiences because, "women more often experience sexual abuse and rape, whereas men are more frequently traumatized by physical attacks and serious accidents" (Gavranidou and Rosner, 2003). In addition, there were also no definite differences with respect to gender in the accounted traumatic incidents such as death of a loved one or natural disasters in the studies reviewed by the two researchers. Each gender seemed to have their patterns of traumatic experiences. As cited by Gavranidou and Rosner (2003), "the probability of developing post traumatic stress disorder differs according to the type of traumatic event". Given that rape and sexual abuse are apparently more disturbing and more common to women than life threatening experiences in men; women are therefore understandably more exposed to developing the disorder. Simply said, reported and unreported cases of sexual abuse are more common in women than men. It is still important to note that rape and sexual abuse in both genders results to a high risk of developing the disorder. Gavranidou and Rosner (2003) however gave possible explanations why the results of the studies they reviewed gave those analyses. One is that there could be bias in the methodologies used in their studies like stressors surveyed are more inclined to situations common to men and that most of the studies utilize self-reports and clinical interviews. Reluctance or openness in giving testimonials is highly affected by gender due to the social rules that men and women play in the society. As Gavranidou and Rosner (2003) explains, "women are expected to be more passive or weak" which makes them more inclined to share their experiences than most men. On the other hand, men are expected to be the stronger gender and thus more reluctant to tell others of their traumatic experiences for fear of being maligned. Men and women also differ in the way they adjust their emotions and interpret the meaning of an event after a traumatic experience occurs. Men tend to make light of the event or take up the role of hero when telling others of the experience. Women on the other hand tend to react with much blame on themselves. Socio-economic Status An individual's socio-economic status dictates a man's capacity to cope up with the pressures and needs of living in the society. While people with higher social-economic capacity have probably more than what they need, people with lower social-economic have to do tedious jobs to fill their basic needs. People with higher social-economic status are educated or education is readily available while people with lower social-economic status tend to have lower educational attainment. In times of traumatic experiences, it is therefore apparent that there is a big difference in how people cope up with experiences due to their socio-economic status. In Davidson, Kigamwa, Nicholls, Njenga and Nyamai's (2004) study, although the majority of the subjects were educated and professional individuals, the other subjects had apparently lower socio-economic status. The results of their analysis showed that along with having a female gender, having less education was a factor associated primarily with post traumatic stress symptoms. Notable factors associated with post traumatic symptoms were encountering and anxiety of expecting financial difficulties after the bombing. People of all social and economic class have traumatic experiences, but people living in poverty are most likely to experience more traumatic experiences such as violence. Violence for the most part is highly associated to poverty, lack of good education, discrimination of women and etc. Gavranidou and Rosner (2003) further stressed that in studying the implications of traumatic experiences, the probability or intensity of traumatic experiences that coincides with the society or the place where the subjects reside should also be considered. Pre-existing Psychological Conditions A person's mental state, character and previous experiences with traumas are big factors on how he/ she react in times of tragic and distressing events. To study the extent to which previous trauma encounters, mental condition along with demographics are risk factors for developing post traumatic stress disorder, Christensen, Jorm and Parslow (2006) considered 2,085 young adults from the Australian Capital Territory and its vicinity. They were previously interviewed in 1999 during a community-based survey and thus considered for this study because they were viable candidates to give unbiased information prior to the traumatic event. When a major bushfire happened in their area, the 1999 participants were again interviewed 4 years later within a period of 3-18 months after the incident. The interviews revealed that 80% of the participants were exposed to the fire and that 50% claimed on having irrepressible traumatic experiences (Christensen, Jorm and Parslow, 2006). When screening criteria was applied to the remaining participants, 5 % were evaluated with post traumatic stress disorder of which 74% were females. In addition, 6% of those who were found to be positive with the disorder had an immediate experience with the bushfire. Using analysis of Variance and chi-squared tests, the researchers were able to conclude that along with "being a female, pre-trauma depressive and anxiety symptoms, level of neuroticism and having prior experience of trauma were significantly" related to developing post traumatic stress disorder after the disaster. It was also shown that there is a range of expected reactions depending on a person's prior exposure to trauma. Summary and Conclusions The results and discussion of these three studies, simultaneously shows that having the female gender is the most crucial risk factor in acquiring the disorder. Gavranidou and Rosner (2003) reviewed several studies done on risk factors for post traumatic stress disorder that focused on the aspect of gender. They further attempted to explain the effects of gender in developing post traumatic stress symptoms through the differences in the types of trauma that men and women experience and their respective reactions to trauma. The three studies also showed that socio-economic status proves to be one of the primary risk factors of people's vulnerability in developing the disorder. On the other hand, Christensen, Jorm and Parslow (2006) showed that besides the gender factor and socio-economic status, pre-trauma experiences and mental condition prior to a trauma are also important elements in the development of post traumatic stress disorder after a traumatic experience. The recent studies examined in this paper only shows that it is important to do such research given that there are several risk factors for developing post traumatic disorder Reference Christensen, H., Jorm, A.F., & Parslow, R.A. (2006). Associations of Pre-trauma Attributes with Screening Positive for PTSD: Analysis of a community-based study of 2085 Young Adults. Psychological Medicine, 2006, 36, 387-395. Retrieved 27 November 2006 from Davidson, J. R.T., Kigamwa, P., Nicholls, P.J., Njenga, F.G., & Nyamai, C. (2004). Post-traumatic Stress After Terrorist Attack: Psychological Reactions Following the US Embassy Bombing in Nairobi; Naturalistic Study. British Journal of Psychology (2004), 185. 328-333. Retrieved 27 November 2006 from http://bjp.rcpsych.org/cgi/reprint/185/4/328 Gavranidou, M. & Rosner R. (2003). Theoretical Review; The Weaker Sex Gender and Post-Traumatic Stress Disorder. Depression and Anxiety 17 :130-133 (2003). Petty, F., PhD.,M.D., (2000). Post-Traumatic Stress Disorder: Brain Disease for the New Millennium. Targeted Publishing Group, Inc. Retrieved 27 November 2006 from http://www.addictionrecov.org/paradigm/P_PR_W00/stress_disorder.htm. Read More