Post-Traumatic Stress Disorder - Research Paper Example

A Correlational Study of the Relationship between the Length of Time Served in a Combat Zone and PTSD Abstract PTSD is an increasingly common diagnosis for soldiers returning from areas of active combat in the US military. This study will examine the correlational relationship between the length of a tour of duty in an active combat zone and the incidence of PTSD in the five years following. Two groups of soldiers, one scheduled for a short tour of duty of less than six months, the other an extended tour of a year or more, will be examined by a psychologist prior to leaving the United States for a tour of duty in an area of active combat. It has been hypothesized that due to the increased incidence of psychological trauma experienced by soldiers serving an extended tour of duty in an area of active combat, those soldiers who remain in the war zone for a year or more will be more likely to experience severe Post Traumatic Stress Disorder than their short term counterparts. This hypothesis will be tested upon their return to the United States, where they will be given a full psychological examination before being permitted to return to regular duty. These soldiers will then be examined every three to six months for the next five years in order to identify the manifestation of any potential symptoms of PTSD. Introduction The increasing quantity of American soldiers serving in combat zones overseas has sparked an exponential increase in the incidence of diagnosed Post Traumatic Stress Syndrome. PTSD is defined by the National Institute for Mental Health as “an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened”, and manifestation of symptoms can be extremely debilitating. PTSD became a mainstream disorder following its discovery in war veterans, but symptoms can manifest in any individual who has suffered or witnessed a traumatic event. PTSD is seen in victims of rape, mugging, torture, kidnapping, child abuse, car accidents, train wrecks, plane crashes, bombings or natural disasters. Currently there are approximately 7.7 million adults and an unknown quantity of children and teenagers suffering from PTSD in the United States. (NIMH, 2008) PTSD is notable for its inconsistency. Only a percentage of those individuals who have suffered or witnessed a traumatic event will develop PTSD, and the extent of their symptoms will vary. (NIMH, 2008) An individual who has witnessed the rape of a family member may develop severe PTSD, while a soldier who has spent years being tortured as a POW may manifest no symptoms whatsoever. One victim may show signs of PTSD within days of the event, another many years following. In order for a definitive diagnosis of PTSD to be made symptoms must persist for thirty days or longer. (NIMH, 2008) The disorder may manifest itself as persistent flashbacks or nightmares of the event that leave the victim feeling emotionally numb and detached from the people and places that were closest to them. (These feelings of general apathy were what led to the disorder’s classification of “battle fatigue” or “shell shock”.) (Grohol, 2006) Victims of PTSD may make associations during the day that cause them to experience the event or the emotions surrounding the event over again, and viewing things or people related to the event may be particularly distressing. Anniversaries of the event are often difficult, and the victim is likely to avoid any thoughts, feelings or conversations associated with the trauma they have suffered. (Grohol, 2008) Symptoms of PTSD may be accompanied by depression and/or suicidal tendencies and difficulty interacting with others in social situations. (Grohol, 2006) Occasionally PTSD will manifest itself as unpredictable and unfounded bouts of rage and an exaggerated startle reaction, and it is often accompanied by sleep disturbances and changes in normal behavior patterns. (Swierzewski, 2007) It is not unusual for victims of PTSD to turn to substance abuse in an attempt to seek relief from their internal nightmares. (Dryden-Edwards, 2007) There are many methods for diagnosing PTSD. Self-tests are available through the National Institute of Mental Health. Victims of traumatic events that present with bipolar disorder, depression, eating disorders, obsessive compulsive disorder, panic disorder and other types of anxiety related symptoms are suspected of PTSD and evaluated by a medical professional. (Dryden-Edwards, 2007) A professional diagnosis of PTSD will be based upon the manifestation of symptoms from three classes of symptoms, as indicated by the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Re-experiencing symptoms of the event consist of recurring nightmares, flashbacks, intrusive thoughts or an exaggerated emotional and physical response to reminders of the event. Avoidance or numbing symptoms display feelings of detachment or alienation, attempts to avoid situations that remind the victim of the trauma, a loss of interest in activities which the patient had previously enjoyed and “the inability to feel affection or emotion in ways the person had previously experienced emotions.” (Pearson, 2008) Hyperarousal symptoms manifest themselves as difficulty in concentration or remembering, hypervigilance, insomnia or other sleep disturbances, outbursts of anger and general irritability. (Healthcommunities.com, 2008) Sometimes PTSD will correct itself within a span of six months as they adjust to the normality of their lives as they were before the event. For others PTSD will become a chronic condition. Therapy may or may not prove to be effective, although studies have shown that early treatment with certain kinds of medication and psychotherapy can give the victim a best odds chance of regaining the quality of life they had before the event. (NIMH, 2008) Psychiatric professionals working with individuals with PTSD will often practice psychotherapy methods that center around helping the victim deal with the trauma. These victims are counseled in strategies to control their symptoms and encouraged to discuss the event in detail (thus ensuring that they see it in its proper light and have not exaggerated the incident in their mind or assigned blame where it does not belong). This counseling may take the form of group therapy as the victim’s family and friends learn how to provide the patient with as much support as possible. (Dryden-Edwards, 2007) If conventional treatments fail or the victim’s symptoms are too severe to allow them to attempt to manage the disorder on their own a round of narcotic therapy may be recommended. Medications used to treat PTSD include SSRIs (seratonergic antidepressants) such as Prozac, Zoloft or Paxil combined with Catapres, Tenex or a propranolol that will relieve their physical symptoms. If the patient suffers from mood swings they may be given a mood stabilizer, such as Lamictal or Depakote, or an antipsychotic mood stabilizer such as Risperdal, Zyprexa and Seroquel. (Dryden-Edwards, 2007) Victims who are treated with an antidepressant for at least a year have been shown to have a much lower incidence of relapse than those who undergo a shorter course of treatment. SSRIs decrease the anxiety, depression and panic which spawn PTSD symptoms, also serving to reduce aggression, impulsivity and suicidal thoughts. If the patient suffers from agitation, dissociation, hypervigilance, intense paranoia and brief psychotic episodes an antipsychotic may prove to be the most effective form of treatment. (Dryden-Edwards, 2007) The prognosis for victims of PTSD who seek treatment immediately following the event is very good. CISD (Critical Incident Stress Debriefing) can decrease the severity of a response to the event and may avert PTSD altogether. For those who develop chronic PTSD the remainder of their lifetime is likely to be an ongoing series of relapses and remissions. Although they may eventually overcome the worst of their trauma and regain the majority of their emotional stability these patients may continue to have flashbacks or nightmares thirty to forty years after the event takes place. (Bayse, 1998) Materials and Methods This experiment requires two units of soldiers with a similar history of past combat experiences that are due to serve a tour of duty in an active war zone and a medical staff familiar with the mental and physical strain of PTSD. One unit of soldiers must be scheduled to serve a short tour of duty, six months or less. These will be the test subjects for short term exposure to active combat and its relation to PTSD. The second group will represent the effects of long term exposure and should be due to serve a tour of duty of a year or more. Ideally both units would be bound for the same destination, allowing for fewer variables in their experiences. Prior to their departure from the United States both units of soldiers will be evaluated, mentally and physically, by the medical staff. This evaluation will serve to confirm their general physical and mental preparedness for entering into active combat and eliminate the likelihood of another physical or mental condition that could sway the experiment and/or predispose them to PTSD prior to entering the combat zone. If a member of a unit is found to be suffering from a physical or mental condition that places them at a greater risk for the development of symptoms of PTSD they should be removed from the study immediately. Both units will serve their entire tour of duty, then return to the United States. Within one week of their return they will be evaluated by the medical staff to determine the manifestation of any symptoms of PTSD. If symptoms have manifested it will be noted, as well as their severity. Assuming they are mentally and physically able the units will then be free to return to normal duty, returning for another evaluation of their physical and mental condition every six months for the next five years. Diagnosis of symptoms of PTSD will be made following the administration of the PDS Assessment Test, which will be given both before and after the unit’s departure from the United States and at each subsequent follow up. Individuals who manifest symptoms of PTSD should return every three months to allow an accurate determination of the severity and progression of their symptoms while at the same time actively seeking treatment. When the five years of evaluation have passed the medical staff will then compare their records and reach a firm conclusion as to which unit was found to have suffered greater consequences with regard to PTSD following their tour of duty. Conclusion The study is most likely to show that due to an increased exposure to traumatic experience and the continuous mental preparedness required in the face of constant threat of physical harm, the individuals in the unit serving an extended tour of duty will show an increased incidence of severe manifestation of symptoms of PTSD. Read More

In order for a definitive diagnosis of PTSD to be made symptoms must persist for thirty days or longer. (NIMH, 2008) The disorder may manifest itself as persistent flashbacks or nightmares of the event that leave the victim feeling emotionally numb and detached from the people and places that were closest to them. (These feelings of general apathy were what led to the disorder’s classification of “battle fatigue” or “shell shock”.) (Grohol, 2006) Victims of PTSD may make associations during the day that cause them to experience the event or the emotions surrounding the event over again, and viewing things or people related to the event may be particularly distressing.

Anniversaries of the event are often difficult, and the victim is likely to avoid any thoughts, feelings or conversations associated with the trauma they have suffered. (Grohol, 2008) Symptoms of PTSD may be accompanied by depression and/or suicidal tendencies and difficulty interacting with others in social situations. (Grohol, 2006) Occasionally PTSD will manifest itself as unpredictable and unfounded bouts of rage and an exaggerated startle reaction, and it is often accompanied by sleep disturbances and changes in normal behavior patterns.

(Swierzewski, 2007) It is not unusual for victims of PTSD to turn to substance abuse in an attempt to seek relief from their internal nightmares. (Dryden-Edwards, 2007) There are many methods for diagnosing PTSD. Self-tests are available through the National Institute of Mental Health. Victims of traumatic events that present with bipolar disorder, depression, eating disorders, obsessive compulsive disorder, panic disorder and other types of anxiety related symptoms are suspected of PTSD and evaluated by a medical professional.

(Dryden-Edwards, 2007) A professional diagnosis of PTSD will be based upon the manifestation of symptoms from three classes of symptoms, as indicated by the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Re-experiencing symptoms of the event consist of recurring nightmares, flashbacks, intrusive thoughts or an exaggerated emotional and physical response to reminders of the event. Avoidance or numbing symptoms display feelings of detachment or alienation, attempts to avoid situations that remind the victim of the trauma, a loss of interest in activities which the patient had previously enjoyed and “the inability to feel affection or emotion in ways the person had previously experienced emotions.

” (Pearson, 2008) Hyperarousal symptoms manifest themselves as difficulty in concentration or remembering, hypervigilance, insomnia or other sleep disturbances, outbursts of anger and general irritability. (Healthcommunities.com, 2008) Sometimes PTSD will correct itself within a span of six months as they adjust to the normality of their lives as they were before the event. For others PTSD will become a chronic condition. Therapy may or may not prove to be effective, although studies have shown that early treatment with certain kinds of medication and psychotherapy can give the victim a best odds chance of regaining the quality of life they had before the event.

(NIMH, 2008) Psychiatric professionals working with individuals with PTSD will often practice psychotherapy methods that center around helping the victim deal with the trauma. These victims are counseled in strategies to control their symptoms and encouraged to discuss the event in detail (thus ensuring that they see it in its proper light and have not exaggerated the incident in their mind or assigned blame where it does not belong). This counseling may take the form of group therapy as the victim’s family and friends learn how to provide the patient with as much support as possible.

(Dryden-Edwards, 2007) If conventional treatments fail or the victim’s symptoms are too severe to allow them to attempt to manage the disorder on their own a round of narcotic therapy may be recommended. Medications used to treat PTSD include SSRIs (seratonergic antidepressants) such as Prozac, Zoloft or Paxil combined with Catapres, Tenex or a propranolol that will relieve their physical symptoms.

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