Treatment, Diagnosis, Causes of Post-Traumatic Stress Disorder - Assignment Example

Posttraumatic Stress Disorder Background Post-traumatic stress disorder is a mental health condition that may develop in a person exposed to a traumatic or stressful event. In this type of mental disorder, the body’s reaction to danger is somehow damaged or changed. It is important to note that the fear resulting from exposure to danger is responsible for causing many other body split-second changes. These reflexes or changes are a way through which the body prepares to fight that danger or try and avoid it. Individuals who suffer from post-traumatic stress disorder develop the condition from a terrifying ordeal that might have resulted in a threat of harm or exposure to harm itself. Such persons might have been the primary victims, or the ordeal occurred to their loved ones. Terrifying events develop intense fear and a feeling of powerlessness and may be warfare, sexual assaults or threats of imminent death (Yehuda, 2002). Other ordeals could be torture, child abuse, plane crashes, accidents, bombings or train wrecks. Individuals who suffer from this disorder tend to feel frightened or stressed even after they are safe and sound. Recurring flashbacks, nightmares, hyper arousal and irrepressible thoughts about the event that continue for a relatively long period after the event are common symptoms. Other symptoms include feelings guilt, irritability or isolation as well as lack of sleep and concentration. This disorder can occur immediately after the ordeal or after a given period. Cases of Post-traumatic stress disorder became rampant following the First World War 1914-1918. This occurred after soldiers fighting in the war begun developing shell shock from the trenches’ harrowing conditions. The disorder was however never recognized officially as one of the mental conditions until 1980. At that moment, PSTD was accommodated in the mental disorders’ diagnostic and statistical manual that is a product of the American Psychiatric Association. Post-traumatic stress disorder is more likely to develop in women than in men, though both may experience similar traumatic events (Skelton et al., 2012). The risk of developing PTSD in children under the age of ten is lower than in adults. Causes Several factors have been associated with the cause and development of PTSD, and they include family violence, substance abuse, genetics, damage of some brain areas and foster care. Studies support that trauma of family violence can predispose a person to PTSD especially children and women. Child abuse may increase the risk of that person to experience PTSD at older ages (adult) as he/she may start having intrusive memories, flashbacks and even nightmares on those past events. PTSD patients are unable to specify the context and time of these traumatic events and experience sensory episodes that aggravate and continue PTSD symptoms. These re-experiences of the trauma happen as if it’s present, however long ago it might have happened. Some children may be inadvertently exposed to violent behaviors in an attempt to manage emotional deregulation caused by their PTSD parents (Skelton et al., 2012). If these children arent treated adequately in time, they may develop PTSD symptoms in adulthood, depending on the severity of the trauma. Genetics has been associated with PTSD in that the risk to PSTD is hereditary. PTSD has common genetic influences as other psychiatric disorders. For example, it shares 60% genetic variance with panic and generalized anxiety disorders. By use of the neurotransmitter Gamma-aminobutyric acid (GABA), which is an inhibitory neurotransmitter in the brain, the severity of childhood trauma can be used in predicting PTSD in adults. This is due to the interaction of the trauma and alpha-2 receptor gene in the GABA. In recent times, some single-nucleotide polymorphisms in FKBP5 have been used to predict rigorousness of PTSD in adults as they interact with childhood trauma. Individuals who have been abused when they were children and have these SNPs are at more risk to develop PTSD (Falsetti, Monier&Resnick, 2005). These genes are favored to be expressed by the traumatic environment the person is exposed to. Genes responsible for the synthesis of gastrin-releasing peptide (GRP) and stathmin appear to be malfunctioned in cases of PTSD. Stathmin is a type of protein that is required by the body to form fear memories. Persons who do not synthesize stathmin are less likely than normal individuals to protect themselves from danger. They tend to show less innate fear through which they go ahead to explore the danger more willingly. Gastrin releasing peptide is a kind of signaling chemicals of the brain that are synthesized during emotional events. GPR is known to control the responses to danger. The absence of this chemical results in the creation of more lasting and greater memories of fear (Brewin, Andrews & Valentine, 2000). Some of the brain areas are also known to cause post-traumatic stress disorder upon their malfunctioning. A good example of such structures is the amygdala that is common for learning, memory as well as playing an important role in emotion. In cases of a frightening ordeal, the amygdala is always active in the acquisition of fear. The amygdala is also active in earlier stages of fear extinction or during the process of learning not to fear. The process of dampening original fear responses or storing extinction memories is another important function of the prefrontal cortex region of the brain. This brain area is involved in some tasks that include problem-solving, decision-making as well as judgment. It is important to note that different areas of the prefrontal cortex serve different functions. For instance, during an event where the source of stress is deemed controllable, the prefrontal cortex initiates a suppression on the amygdala. The latter acts as an alarm center in the brainstem and works to control the individual’s response to stress. The differences in terms of the composition of the brain areas and the genes are behind the progression of PSTD without causing any symptoms. The risk of exposure to PSTD is raised by environmental factors that include head injury, childhood trauma or even a family history of mental illness. Cognitive and personality factors such as the tendency and optimism to face problems in a negative or positive way are some of the PSTD’s psychological factors. Social factors such as the ease of access to social support also change the manner in which individuals react to trauma (Nelson, 1996). Drug abuse affects one mental status and also increases the anxiety levels. This is also common in alcohol abuse. These conditions can lead to the development of PTSD and also can worsen or hinder recovery from the disorder. An increase in the release of endogenous norepinephrine caused by Yohimbine leads to increased arousal and can worsen PTSD symptoms. Most children who are abused sexually or physically are likely to have PTSD symptoms in adulthood. Also, those who are not abused may develop the same due witnessing such traumatic events happening to their colleagues. Statistically, the number of adults with PTSD who were in foster care is higher (25%) than that of Vietnam War veteran (15%). Their recovery rate was low (28.2%) as compared to 47% in general showing how severe childhood abuse may be to people. This study is the Casey Family Northwest Alumni Study (Brewin, Andrews & Valentine, 2000). In War veterans, PTSD symptoms can develop, especially after cruel treatment and inhumane torture when imprisoned (prisoners of war). Exposure to atrocities, combat or accidents affects these soldiers’ mental health and can experience persistent acute perceptional, cognitive or emotional responses. These behaviors may lead to PTSD if not intervened early. Pathology High levels of stress and fear hormones are released in the course of traumatic experiences; these hormones are crucial in the development of PTSD. There are major changes in the biochemical composition of the brain with low cortisol secretion while the catecholamines are high in the urine and also corticotrophin-releasing factor concentrations are high. Therefore, in PTSD patients, the HPA axis is abnormal based on the strong negative feedback inhibition of cortisol and heightened negative feedback dominance by dexamethasone. This is why PTSD patients respond intensely to a dexamethasone suppression test. Flashbacks and nightmares can be linked to the over-activation of norepinephrine receptors in the cortex caused by hyper-responsiveness in the norepinephrine system (Yehuda, 2002). Diagnosis and Treatment Following the decision to visit a psychologist, the following criteria is considered for the diagnosis of the condition. First, there have to be one or more re-experiencing symptoms, three or more avoidance symptoms, and two or more hyper-arousal symptoms. There is no clear cure for this condition, but therapies have given positive results in managing PTSD if administered in the early stages of the traumatic incidence. The various components of cognitive behavioral therapy such as exposure therapy, cognitive restructuring, and stress inoculation training are used when treating cases of PSTD (Yehuda, 2002). Medication is also deployed when managing cases of PSTD. These include Beta blockers such as propranolol that blocks adrenaline’s effect on the amygdala hence preventing over-arousal and also the formation of traumatic memories. Glucocorticoids are also useful as they help treat septic shock following a surgery and can prevent PTSD if administered just after the traumatic event. Sertraline and paroxetine are a group of antidepressants that are used to curb the depression accompanying PSTD. The antidepressants control symptoms such as worry, anger or sadness. Other medications include benzodiazepines that help in solving anxiety and insomnia problems. Antipsychotics is also another class of drugs that are used to manage cases of PSTD (Nelson, 1996). Conclusion PTSD is a type of mental disorders that is categorized under DSM-V. There includes several causes of the disorder ranging from drug abuse to genetics. It is however, treatable through early medication or therapy. Psychotherapy involves the prowess of a psychiatrist as well as the assistance of the victim’s family and friends. References Brewin C, Andrews B & Valentine J. (2000). Meta-analysis of Risk Factors for Posttraumatic Stress Disorder in Trauma Exposed Adults. Journal pf Consulting and Clinical Psychology, 68(5), 748-766. Falsetti S, Monier J & Resnick J. (2005). Chapter 2: Intrusive Thoughts In Posttraumatic Stress Disorder. In D. Clark, Intrusive Thoughts In Clinical Disorders. Theory, Research, and Treatment (p. 40). The Guilford Press. Nelson, C. B. (1996). Posttraumatic Stress Disorder in The Ntional Cmorbidity Survey. Archives of General Psychiatry, 1-14. Skelton K, Ressler KJ, Norrholm D, Jovanovic T & Bradley-Davino T. (2012). PTSD and gene variants: New pathways and new thinking. Neuropharmacology 62 (2), 628–637. Yehuda, R. (2002). Post-Traumatic Stress Disorder. The New England Journal of Medicine. 346 (2), 1-7. Read More