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Post-Traumatic Stress Disorder is defined its characteristic of provoking fear, helplessness or horror to witnesses of traumatic events in response to threat of injury or death. To be given the PTSD diagnosis someone must have been exposed to an intense stressor or traumatic…
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Post Traumatic Stress Disorder Brenda A Smith Argosy April 27th Post-Traumatic Stress Disorder is defined its characteristic of provoking fear, helplessness or horror to witnesses of traumatic events in response to threat of injury or death. To be given the PTSD diagnosis someone must have been exposed to an intense stressor or traumatic incident to which they responded with fear, helplessness, or horror. The symptoms of PTSD are readily identifiable by a primary care physician (Yehuda, 2002). The nature of someone’s past and the nature of trauma itself both appear to play important roles in a person experiencing PTSD. The person must have been exposed to an actual threat of death, serious injury or sexual violence. This research seeks to ratify literature on a collection of issues about PTSD; the extent and nature of PTSD, treatment and issues of diversity on the same and the diagnosis and differentiation. Moreover, more information will be provided on diagnosis and culture of the disorder. The information will be inculcated in the information obtained from an interview with PTSD specialist from Boston, Dr. Alejandro Mendoza with much of his information basing on his experience and data from Massachusetts (Check appendix 1 for his brief medical biography).
Extent and Nature of PTSD
According to research, PTSD affects as many as one in fourteen adults and adolescent at one time in their lives and one in 100 children before they begin kindergarten. This is also applicable to the case in Massachusetts where 7% of the children develop the condition at kindergarten. These trauma- related events have been as some of the most costly health problems. Events that involve interpersonal violence such a rape or sexual violence give rise more to PTSD than other events. According to Yehuda (2002), PTSD developed in 55 percent of persons who reported being raped. Statistically among adults who have reported having experienced a traumatic sensor are women who are twice as many as men. Certain types of traumatic events have high conditional probability of being followed by PTSD for example rape, childhood sexual and physical abuse, war and combat among others (Ford, 2009). From the interview with Dr Alejandro Mendoza, it was established that rape victims have more trauma in especially given the other conditions associated with the same.
Diagnosis and Differentiation
Psychiatrists have determined that PTSD should be diagnosed after a moth has elapsed since the trauma. If a person is suffering from PTSD they will exhibit three categories of symptoms that distinguish them from other mental health issues, these symptoms include re-experience of the traumatic event through nightmares and flashbacks, second involves avoidance, where the person will want to stay away from anything that reminds them of the trauma and may exhibit a general lack of responsiveness to all life circumstances. Third symptom is hyper arousal; this comes as a result of irritability and lack of sleep by the sufferer. The sufferer has difficulty in concentrating; they become more vigilant and concern about safety and they get exaggerated startle reactions in response to sounds or movements (England, 2009). Though these symptoms are universal, Dr. Mendoza determined that there are special cases of veteran soldiers that experience higher levels of many of these symptoms in the region than any other group of people.
There is no single established cause of PTSD but it appears to involve many interrelated changes in the body stress response system and the rain emotion regulation systems that are associated with extreme sensitivity to danger and self-protective adaptations to promote survival.
The symptoms of posttraumatic stress disorder (PTSD) may seem similar to those of other trauma or anxiety disorders; however, there are distinct differences (refer to appendix 2). Generally, in acute stress disorder the symptoms must manifest within four weeks of a traumatic event and end within that same period of time. If the symptoms last longer than one month and seem follow other patterns that are common to PTSD, the diagnosis may change from acute stress disorder to PTSD. PTSD recurrent and intrusive thoughts can be distinguished from other conditions because they must be invariably connected to a past traumatic event. The traumatic stressor in PTSD must be severe and outside the normal human experience. Some of the other disorders within the same diagnostic category include Major Depressive Disorder, Acute Stress Disorder and Obsessive-Compulsive Disorder (Breslau, 2001).
Treatment and diversity of views or dissent
Treatment of PTSD can be categorized in three ways to include counseling, medication and referrals. Counseling includes the provision of information and education to the sufferer as well as providing a feeling of safety and support. This is done by a primary care provider who helps patient understand the nature of their condition and the process of recovery. There are several primary therapists in Massachusetts that help provide the required support to the victims. They provide a safe space and offer a non critical ear to the patients and emphasizes the patients are not alone. Most patients are reluctant in seeking professional help due to various reasons like lack of self-esteem, fear of consequences among others. Supportive counseling helps eliminate these barriers and make the patients comfortable. This kind of treatment requires special technique to help patient confront their fear and emotional responses towards the traumatic event experienced in a structured way and controlled environment without getting overwhelmed. It involves reducing the distress level that is associated with memories of the event and quelling the resultant physiological reaction. Therapy and counseling maybe in different forms such as exposure therapy, cognitive therapy, anxiety management, interpersonal therapy or group therapy all involved in reducing isolation and stigma.
Medication prescribed by a primary care physician is also helpful to traumatized persons; they help alleviate the symptoms of PTSD and improve the overall functioning of the individual. Therapy and medication, they should be used together to treat PTSD and reduce symptoms. The medications consist of Antidepressant, Beta-blockers for high blood pressure, Mood stabilizers and Sleep restoration medicines. Referrals happen when a patient is in need of specialized treatment, if the initial interventions were not successful or the patient develops side effects to prescribed medication (Breslau, 2001).
Diagnosis and culture
Studies have made attempt to identify differences in the way PTSD occur among ethnic groups. Research has been conducted among veterans ad there has been no clear established pattern but it appears most ethnic minority veteran population have higher incidences of PTSD than whites, this has can be due to an exposure to a higher level of combat stress or due to culturally different ways of reporting symptoms. Native American veterans have been reported to have high levels of PTSD, and this may be related to difficulties in accessing quality care in remote regions. Ethnic groups that have had higher rates of prior traumas, major depression or substance use may experience high rates of PTSD. The Massachusetts population is based on the following racial groups from majority to minority.
Racial Composition
Percentage of Total Population (%)
1
White
83.2
2
White(Non-Hispanic)
75.1
3
Hispanic
10.5
4
Black
8.1
5
Asian
6.0
6
Native
0.5
7
Other race
0.1
8
Two or more races
2.1
Source: England (2009)
The discussion by Dr. Mendoza sought to approve the issue of racial lines in the area. From the table above, the number of Asians, whites, blacks and white non-Hispanics is very significant. Therefore, the effects of PTSD among these groups can openly be felt. The table also approves of the facts that the blacks and Asians are minor groups. The blacks are especially economically disadvantaged and this leads to them having more stress than the other groups. It is also common among immigrants all over the world such as people who fled harsh conditions or military regimes or who endured danger, confinement or threats when entering the country. Sexual orientation may also be a contributing factor where people who are gay, lesbian, bisexual or transgendered are more likely to experience violence and therefore may be more likely to develop PTSD.
References:
Breslau, N. (2001). The epidemiology of posttraumatic stress disorder: what is the extent of the problem? Journal of Clinical Psychiatry.
England, D. (2009). The post traumatic stress disorder relationship: How to support your partner and keep your relationship healthy. Avon, Mass: Adams Media.
Ford, J. D. (2009). Posttraumatic stress disorder: Scientific and professional dimensions. Amsterdam: Elsevier/Academic Press.
Yehuda, R. (2002). Post-Traumatic Stress Disorder. New England Journal of Medicine, 346(2), 108-114.
Appendices
Appendix 1: Short Biography of Dr. Alejandro Mendoza
Dr. Alejandro Mendoza is Chair, Department of Psychiatry, and Medical Director of the Senior Behavioral Health Center at Jordan Hospital in Plymouth. Additionally, he is Chief of the Division of Psychiatry at South Shore Hospital and Assistant Clinical Professor of Psychiatry at Tufts University School of Medicine. Dr. Mendoza completed his internship, residency, and fellowships at Harvard Medical School. He has subspecialty board certifications in Geriatric Psychiatry, Psychosomatic Medicine, and Addiction Psychiatry through the American Board of Psychiatry and Neurology. In 2013 at the 31st NAMI Massachusetts Annual Convention, he was voted as the psychiatry of the year. This gives him much knowledge and experience on matters related to PTSD.
Questionnaire
1. What is the possible approximated rate of PTSD infection rates in the Massachusetts region?
ANSWER:
There are very many causes of the infection and there are also different groups of people; the children, the adults, the soldiers, the students etc. Rates vary from group to group but 7%-8% is the average. This is also the rate for the average American in Massachusetts
2. Would you determine to me the common causes of PTSD in Massachusetts?
ANSWER
That varies from person to person. The common causes are due to:
Something that occurred in the persons life
Something that occurred in the life of someone close to him or her
Something the person witnessed
Examples of these include:
Serious accidents (such as car or train wrecks)
Natural disasters (such as floods or earthquakes)
Man-made tragedies (such as bombings, a plane crash)
Violent personal attacks (such as a mugging, rape, torture, being held captive, or kidnapping)
Military combat
Abuse in childhood
3. With these weird experiences, what are the common and specific symptoms of the condition?
ANSWER:
There are no universal symptoms. Each experience determines the symptoms that will be exhibited. However, summing up most of the symptoms that would likely appear to all people are:
Sleep problems
Depression
Feeling detached or numb
Feeling jittery or "on guard"
Being easily startled
Loss of interest in things they used to enjoy
Trouble feeling affectionate
Feeling irritable, more aggressive than before, or even violent
Avoidance of certain places or situations that bring back memories
Re-experiencing the event
Avoiding stimuli associated with the event
Mood and cognitive symptoms
Increased physiologic arousal
4. What is the treatment criterion for the condition?
ANSWER:
Specific treatment for PTSD will be determined by your health care providers in Massachusetts is based on:
Your age, overall health, and medical history
Extent of the disease
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
5. How does PTSD vary across the different cultural lines given that Massachusetts has a collection of different races of people?
ANSWER:
It has been established that PTSD levels vary depending on race. There are higher levels (up to 15%) among the minority groups especially the blacks and Asians. The same is mostly lower (5-6%) among the majority whites.
6. How is Massachusetts dealing with this trend given that it affects such a large crowd of people?
ANSWER
There are very may private psychiatric practitioners in the region (Including mine at Plymouth) from and they offer continuous support until the victims get better. The Massachusetts general hospital has a special wing for taking care of this condition. Read More
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