Post-Traumatic Stress Disorder - Research Paper Example

Post-Traumatic Stress Disorder Introduction and overview of disorder Post-traumatic stress disorder is one of the more severe anxiety disorders defined in psychology. PTSD can occur in people after they have been subjected to psychological trauma, which can be caused by means of any one event that may force a person to feel threatened, or involve death, sexual, physical or psychological virtues. The disorder takes place after the person has experienced the traumatic event. According to the American Psychiatric Association, the diagnostic criteria for PTSD consists of the exposure to a traumatic event; persistent re-experiencing of the event; persistent avoidance and emotional numbing; persistent symptoms of increased arousal not present prior to the event; duration of symptoms last for more than one month; significant impairment (American Psychiatric Association, 2000). This criteria will be viewed in detail, as follows (APA, 2000): 1. Exposure to a traumatic event - for the event to be considered traumatic, and therefore capable of causing PTSD, it must involve a severe negative emotional response and a depletion of integrity or an event that involves the threat of injury or death. 2. Persistent re-experiencing - the victim needs to experience flashbacks of the event, the ability to continually re-experience the event or displaying a negative psychological response to anything that might remind them of the event. 3. Persistent avoidance and emotional numbing - the victim avoids anything at all related to the event, including feelings or thoughts that they associate with the event. They avoid people, places or other stimuli involved in the event; however, they can also be unable to recall some of the more important information of the event. They begin to shut down their emotions, especially if they were experienced during the event. 4. Persistent symptoms of increased arousal not present before - the victim begins to experience things that they did not prior to the event, such as sleeplessness, issues controlling their anger, having difficulty concentrating, and hypervigilance, which is the victim’s ability to be overly sensitive to danger or potentially harmful situations. 5. Duration of symptoms for more than one month - if the victim experiences the typical symptoms of PTSD and they do not subside after a month, they are usually diagnosed with PTSD. 6. Significant impairment - the victim can experience impairment and deterioration of major aspects of life, such as social relationships and intimate relationships, as well as occupation or family life. They begin to stop functioning in normal situations that involve them being around people. Symptoms Post-traumatic stress disorder tends to be one of the more difficult anxiety disorders to diagnose in people as many of the symptoms are similar to other anxiety disorders, as well as disorders that are unrelated to anxiety. One of the first things that doctors look for when attempting to diagnose a patient with post-traumatic stress disorder is whether or not they have experienced or have been subjected to an event that could be considered traumatic. If no event has occurred, then the patient does not have PTSD. Some events in which a person may be affected, and therefore at risk for PTSD, include rape or attempted rape, a relationship with someone close to them that has turned abusive, any such incident that may require them being close to death or being threatened with death or injury, or seeing someone else in one of the aforementioned situations. If the patient has experienced such an event, the doctors look towards the rest of the alleged symptoms of the disorder, which are split up into three categories, in accordance with Patrick Smith (2009). The first category of symptoms involves any method of re-experiencing the traumatic event. Flashbacks, dissociative reliving of the event, nightmares and night terrors, which are a sleeping disorder in which the victim experiences severe terror and has the inability to regain consciousness, are the most common forms of a victim re-experiencing the event. Another symptom includes reliving the event as a memory, though this is not as common as the others, given that the victims strive to forget the incident and therefore do not try to invoke it of their own accord. The second category of symptoms involve the victim becoming paranoid and terrified of anything that may remind them of the event. Places, people and other experiences that remind the victim of the event causes them to avoid these things. Even if they have no direct connection to the event, the victim stays away from them, developing phobias to these things. Certain emotions are also avoided, especially if they bring about flashbacks or memories of the event. Many patients with these symptoms often lose the ability to feel certain emotions and become emotionally numb and unresponsive to other events and situations, even if they would produce positive, cheerful emotions. The victims stop being aware of themselves, which is just another method to help them to forget the conditions of the event; they cannot allow themselves to remember the event if they do everything in their power to avoid any aspect of it. The third category of symptoms includes signs of hyperarousal, such as problems falling or staying asleep, a major lack of concentration, blackouts or trouble in remembering things, or being easily startled. Another symptom in this category is hypervigilance, in which the victim is very aware of threat. People who have experienced traumatic events, especially those that lead to PSTD, often, and usually unconsciously, become aware of their surroundings and begin to trust nothing and nobody. It all has to do with paranoia, as they are expecting that they may be subjected again to something as traumatic as the previous event. They allow themselves to be more in-tune with their environment, suspecting everyone and everything. Other symptoms that can be branched off from the aforementioned symptoms include, but are not limited to, a lack of interest in activities or people, being convinced that they will not live too long and therefore avoid making plans for the immediate future, and distancing themselves from people, especially people that may remind them of the traumatic event. Etiology Post-traumatic stress disorder can be caused by “an event that is life-threatening or that severely compromises the emotional well-being of an individual or causes intense fear (Winn, 1994).” The same definition also applies for an event that is considered to be intensely traumatic to the individual. However, while this is the basic definition as to what can cause PTSD, it is still a vague one. While there are a variety of events that may cause PTSD, there is also an assortment of principles that can cause PTSD, which include: psychological trauma, neuroendocrinology, and genetics. Psychological trauma, as aforementioned, is one of the biggest causes of post-traumatic stress disorder. Physical or psychological trauma can cause PTSD, as well as a combination of both. Witnessing or being a part of physical, emotional and sexual abuse are considered to be traumatic events that can induce PTSD. Experiencing or witnessing other life-threatening events such as assault, accidents involving vehicles, medical complications, disasters, torture, being a hostage or witnessing someone being taken, being bullied and being exposed to war are a variety of things that can cause PTSD in any person. In regard to neuroendocrinology, the resulting symptoms of witnessing or experiencing a traumatic event can cause an overactive adrenaline response. This response has the ability to create deep neurological patterns within the brain (Metcalf, 2009). Even after the event that triggered the fear within the person is long gone, the victim can become hyper-responsive to terrifying situations that may take place in the future due to these patterns in their brain. These patterns how a person reviews and processes a situation that they may be in, or one that they have imagined. Though genetics is the most rare cause for PTSD, as well as one of the most controversial, it is still considered to be a cause. A study was done on a set of identical twins and on a set of non-identical twins, all of whom had been exposed to war. One identical twin had been diagnosed with post-traumatic stress disorder, and its sibling was presented with an increased risk of also getting PTSD. This is as opposed to the pair of non-identical twins; while one had PTSD, the other showed no signs of being susceptible to the disorder (True, Rice, Eisen, et al, 1993). Risk factors for PTSD “Although most people (50-90%) encounter trauma over a lifetime, only about 8% develop full PTSD (Kessler, et al, 1995).” People who have had experience in the military are at risk for post-traumatic stress disorder, as well as other forms of intense violence, whether experienced or witnessed. Even those that have feared going into war, such as when drafts were still required based on a specific age limit were at risk for PTSD. Other people who are at great risk for developing PTSD are medical personnel, more so those that are involved with responding to scenes of accident. The more gruesome and horrific that the accident is, the more risk an emergency response personnel has at developing PTSD. As a whole, people that deal with traumatic events on a daily basis, or on a constant basis, are putting themselves at risk to develop PTSD. Current treatment, management, and intervention/prevention Treatment Treating patients with post-traumatic stress disorder can be a difficult task as there is no one medication or therapy that can target the disorder as a whole. Therefore, PTSD must be treated based on the symptoms that the individual is experiencing. Therapy is always the first treatment method that is sought after. For the patient to overcome their PTSD, they need to overcome their fear of the event that caused it to begin with. Therapists and psychologists that specialize in PTSD, sometimes with the help of hypnotherapists, try to target the event that caused the patient to become so traumatized (Metcalf). Once that has been accomplished, which tends to take time, especially if the patient is so unwilling to remember the event, then the therapist helps the patient to explore and modify the ways in which they think about the trauma, which is a technique often seen in psychotherapy. The therapist helps the patient cope with the event; this normally involves the therapist teaching the patients ways in which to manage their emotions in regard to the event. The administering of therapy is often decided on an individual basis. If the patient is experiencing more than two or three symptoms, they are usually put onto medication to help those symptoms before they are subjected to therapy. Also, the type of symptoms that a patient is displaying will be dependent on when they seek therapy, or a therapy program specific to their needs. If the symptoms can be harmful to others around the patient, such as outbursts or displays of anger, the therapist prescribes them the appropriate medicine before administering a therapy program. Classes, courses, conflict-resolution education and specialized therapy groups are available for family members that have experienced an event that caused one of their own to succumb to PSTD (Smith). These classes also help the patient to regain their communication skills with their family, friends and other close relations. Specialized therapy groups often consist of people who have experienced or witnessed a similar event as the patient, therefore acting as a support group to help them understand and overcome the fear they have towards the situation. As aforementioned, most symptoms associated with post-traumatic stress order need to be treated on an individual basis. Sleeplessness, a lack of concentration, depression and difficulty controlling certain emotions can be treated in the same ways that they would be if they were just individual issues with a person who was not suffering from PTSD. Prozac and Zoloft are very common in the treatment of a few of the symptoms previously mentioned. Management Post-traumatic stress disorder effects three types of people - the person that either witnessed or experienced the event and was later diagnosed with PTSD, other people that witnessed or experienced the same event, and the family and friends of the person that was diagnosed with PTSD. A person with PTSD often shuts themselves down, becoming unaware and no longer acknowledging their former life and the people within that life. They ostracize themselves, not wanting to be near people that may trigger memories of the traumatic event or people that may try to question the person as to the specific details of the event (Smith). This becomes hard for anyone involved with a friend or family member that has been diagnosed with PTSD. To manage a friend or family member that has PTSD, the friend or family in question can look a variety of support groups that will help them to understand what the victim has gone through and how they can help in the healing process. Furthermore, the support groups can prepare the friends and family members for possible symptoms that the victim may display, as well as how to respond to those symptoms. These groups are designed to prepare friends and family for the onset of symptoms, to help them understand why the victim has been diagnosed with PTSD, with a strong emphasis as to what the major factor was in the event that took place, and to support them as they support their victim. Intervention/Prevention One of the most useful techniques to prevent post-traumatic stress disorder is the providing of counseling after a major disaster or traumatic event. This technique can often be seen in schools that have experienced shootings, bombings or the death of a student or teacher. Grief counselors are made available to help the students and teachers to cope with the event or the loss of one of their own. Businesses and companies offer the same services for their workers; Red Cross and the Salvation Army provide counseling after major traumatic events for the sole purpose of avoiding severe cases of post-traumatic stress disorder. The United States Marine Corps, as well as other branches of military, have created programs to help soldiers overcome the events that they have witnessed and experienced, as well as to help the soldiers remain in a fit state of mind in regard to communicating with their family members. Counseling needs to be administered immediately after the event; PTSD does not wait to make itself known in a person. The sooner a potential victim can receive help, the less of a risk they are for developing PTSD, and the quicker they can begin to cope with the event. Conclusion Post-traumatic stress disorder is an anxiety disorder that is caused by a person experiencing or witnessing an event that can be defined as traumatizing; these events usually involve injury, death, or the threat of either of those. While a large portion of the population has the ability to experience or witness a traumatic event in their lifetime, only a small percentage will actually be diagnosed with post-traumatic stress disorder. The diagnosing of the disorder usually involves approximately a month, if not longer, of the victim experiencing a variety of symptoms, as they can be the symptoms of another anxiety disorder or something else entirely. The symptoms of PTSD are many and take place often with someone who has the disorder. Nightmare and flashbacks are some of the most common symptoms that a victim of PTSD may have. PTSD patients also find it hard to concentrate, become paranoid about things and people that were once quite common in their lives, and have difficulty in falling and staying asleep, due to the need to be constantly aware of their surroundings. People with PTSD also either experience emotional outbursts, especially of anger, or begin to lose their ability to display some emotions, such as the ones that they associate with the traumatic event. Those that are at risk for PTSD are people who are subjected to traumatic events on a constant basis, such as someone who is involved in responding to car accidents or a person who has served in war. Treatment for people with PTSD include a variety of therapies that help to pinpoint the event and where within that event the fear is coming from; therapy also helps the patient to overcome their fear and to respond to it rationally and effectively. Individual symptoms are also treated through the use of the same medication that is often used in people who experience some of the symptoms of PTSD without actually having the disorder, such as people who suffer from depression or an inability to fall or stay asleep. Therapy and support groups are also available to family members and friends who have a loved one that has been diagnosed with post-traumatic stress disorder. It is possible to prevent post-traumatic stress disorder in most people. Schools and businesses offer therapy and grief counseling after a major disaster, accident, situation or the death of a fellow student, teacher or employee. The counseling helps the potential PTSD victims to understand what has happened and how to cope with the emotions that come with the traumatic event. This counseling has proven to be vital in the prevention of post-traumatic stress disorder and has helped to curb many onsets of PTSD. It is recommended that counseling be made available after every major traumatic incident, which has prompted non-profit organizations to provide counseling when it is not only deemed appropriate, but important. References American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, Text revision (4th ed). Arlington, VA: American Psychiatric Publishing, Incorporated. Kessler, R.C., Sonnega, A., Bromet, E., Hughes, M. & Nelson, C.B. (1995). “Post-traumatic stress disorder in the National Comorbidity Survey.” Arch. Gen. Psychiatry 52 (12): 1048-60. Metcalf, G. (2009). Post-traumatic stress disorder. Florence, KY: Gale Group. Smith, P. (2004). Post traumatic stress disorder. New York, NY: Taylor & Francis, Incorporated. True, W.R., Rice, J., Eisen, S.A., et al. (1993). “A twin study of genetic and environmental contributions to liability for post-traumatic stress symptoms.” Arch. Gen. Psychiatry 50 (4): 257-64. Winn, L. (1994). Post traumatic stress disorder and dramatherapy. London, UK: Jessica Kingsley Limited. Read More