Section I:Introductory Overview
A. Background and History of PTSD
Many research findings found out that anxiety disorder known as posttraumatic stress disorder (PTSD) is a ubiquitous neuropsychological phenomenon. It happens to almost any individuals, no matter what their age, gender, ethnicities, etc. Being associated with serious traumatic events, it has many characteristic symptoms, such as survivor guilt, lack of involvement with reality, recurrent images and thoughts, numbing and reliving the trauma in dreams. People undergo the reliving of traumatic events via recurrent nightmares or similar threatening scenarios (National Institute of Health, 2014). Individuals with the disorder have excessive distressing feelings triggered by various internal and external factors. For people to shut off severe anxiety-causing events, they resort to emotional anesthesia, psychic numbing, amnesia, among others.
The neuropsychological anxiety disorder is as long as human’s recorded existence. It is caused by a variety of biopsychological factors (for examples, wartimes, sexual assaults and abuse, natural disasters, accidents, robbery, terrorism, serious illness, and so forth). Posttraumatic stress disorder is an old neuropsychological disorder with its current name where survival arising out of fears is considered the main motivating defense for the emotion to take when traumatized. In the 1800s, initial discussions on battlefield traumas among soldiers became more evident. Military physicians diagnosed soldiers for their extreme physical exhaustion and advised them to have some rest from the field. Subsequently, for the years that followed, there had been increasing medicalization of said disorder. The anxiety disorder’s symptoms involve extreme fatigue, dyspnea, heart palpitation, sweating, tremors, and even lost consciousness, and. During wartimes (for examples, US Civil War, First World War), soldiers who experienced the disorder became relatively much higher.
This neuropsychological disorder, as an apparent problem for military physicians during those days, was nevertheless difficult to diagnose because of its nature. Military force were crippled and continued to pose enduring and severe impact. With new thinking arising in the field of medical theories and practices, PTSD was later delineated into psychological and neurological sections. Despite of that, similar to previous postulates, said sectioning later did not stand rigorous medical scrutiny. For example, during the Second World War, soldiers manifested manliness in the face of confrontations and engagements with enemies, but not with combat fatigue, not simply physically, but in trying to avoid inflicting psychological injury. When enlisting to the US forces, neuropsychiatric screening and psychological testing were done to prevent unfit individuals from becoming PTSD victims because of war horrors and atrocities. Despite of that endeavor, soldiers and other military personnel still experienced the disorder.
Nowadays, an increasing number of biomedical researches on PTSD continue to be undertaken. The anxiety disorder, although medicalized, becomes increasingly clinical. The cultural expectation that male strength is preferable among soldiers during wars remains the same. As mentioned above, the anxiety disorder is not only among soldiers and war veterans, but also among young and old individuals who experienced a variety of personal and professional (or work related traumas) such as childhood sexual abuse, incest, car accidents, sexual assaults as in-house employees, and related traumas. Individuals with PTSD, no matter what their genders were, show amnesia and diminished responsiveness. They shut off their feelings and thoughts on other conversations and people even when they were previously close to them. In addition, individuals with the disorder usually have damaged forethoughts the reason their marriage, career and other activities become problematic as a result.
Section II - Discussion III
A. Causes and Associated Factors
Posttraumatic disorder is attributed to suffering traumatic events that makes individuals experience extreme fear, severe helplessness, atrocities, or other types of horrors. However, medical doctors and other experts cannot simply pinpoint precisely as to why people acquire the anxiety disorder. Medical professionals known that it is a complex accumulation of inherited, lifestyle, environmental, and causative factors that serve as extremely potential risks to people’s mental condition, but mostly dependent on the extent and severity of the traumas that affect the normal functioning of the brain for it to maintain internal homeostasis against external stressors.
Many individuals become more prone getting PTSD considering such risk factors as being female, suffering trauma for extensive periods, early experiencing of childhood traumas, insufficient emotional supports from family members and friends, high depression and anxiety levels, history of the disorder or related mental problems, abuse or neglect during childhood, and brain injury. Additional causes of this neuropsychological disorder include, but not limited to shell shock or battle stress, rape, incest and other forms of sexual assaults, robbery, torture, kidnapping, terrorist attacks, car accident, plane crash, civil unrest, fire, and natural disaster. A growing number of studies and treatments show the significance of neurobiological and neuropsychological processes to better understand PTSD. An integrative and heuristic theories (e.g., neurotransmitter reset degradation theory) would help in explicating disparate neuropsychological and socio-cultural findings in literature about PTSD (Kilbourne & Kilbourne, 2011).
B. Signs and Symptoms
The degree and extent of traumatic events suffered by individuals vary. The way in which traumatic events are processed are also dependent on people’s psychological makeup, not to mention the context within which the traumatic event happened. Additionally, PTSD recurs to people in various ways. Individuals with recurring and intrusive recollection of events re-experience traumatic events through recurring distressing dreams. People undergo dissociative states of reliving traumatic events that could last for short whiles to several weeks. Resemblance of the traumatic events triggers extreme psychological distress or physiological reactivity.
In a study conducted Holowka, Marx, Kaloupek, and Keane (2011), they concluded that although there are high endorsement of some particular overall PTSD symptoms, there are “no one symptom cluster [that are] more readily endorsed than others” (p. 3). Among the sample of male Vietnam veterans, those suffering from current PTSD manifested greatest specificity of some particular symptoms (e.g., flashbacks, nightmares). As a caveat, the researchers stated that there are “many symptoms of PTSD [that] are not specific to PTSD per se” or “are not specific to one clinical syndrome” (p. 4); hence, their findings cannot be generalized to other populations (e.g., minority veterans, females, and civilians). They thus claimed that their research results imply that “symptom distribution varies across different target population” and that further research is recommended (p. 7).
People with PTSD usually avoid the Stimuli that activate the trauma. Such individuals will normally use deliberate effort to avoid or outmaneuver or traumatic events, thoughts, feelings, and conversations associated with the trauma. They may attempt to avoid situation, activities and individuals that arouse recollection of past scenarios via amnesia. Individuals with PTSD may use reduced responsiveness to their surrounding through the application of psychic numbness or emotional anesthesia as lasting defensive reorientations. Further PTSD characteristic symptoms consist of unreasonable complaint participating in events previously enjoyed or showing diminished interest, lack of emotional engagement, and unusual detachment, decreased intimacy, dissociative behavior, diminished sexuality, reduced affection, and manifestly less tenderness, . Furthermore, people develop foreshortened future through lack of interests in their career, spouse, children, surroundings, or normal living.
Other symptoms of this anxiety disorder include heightened arousal and increased anxiety before the traumatic events. Accompanying symptoms are difficulty falling asleep due to recurrent nightmares, immoderate wakefulness and excessively startled responses. Other individuals also complain about their anger outbursts other than unrelenting irritability, difficulty concentrating or fulfilling tasks.
C. Clinical Interventions
Many researchers these days focus on neurochemicals (e.g., neuroendocrine alterations) and neuropsychological factors responsible for this anxiety disorder (Pace & Heim, 2011). Some scientists study how specific parts of the neural system give false alarms for post-traumatic disorder to manifest among individuals. With some maintenance drugs, such false alarms are switched off. More promising prevention, clinical interventions, and treatment options are expected to be discovered to help medical experts and professionals in the diagnosis, early detection, and prevention of PTSD.
Furthermore, various preventions, clinical interventions, and treatment options are used for post-traumatic stress disorder. They can be in the different modes, including but not limited to medication, emotional support, religious therapeutic sessions, psychiatric counseling, chemoprophylaxis, pharmacotherapy, and psychotherapy with putative biological and psychological markers. Individuals with PTSD have different appraisals in adapting to sudden changes, self-projecting based on their own mental perspectives, and using control strategies.
D. Diagnostic and Treatment Options
Since PTSD has many potential causes, it requires multiple treatments. Medical practitioners and other healthcare professionals are cautioned that they apply sufficiently necessary care starting with informed consent concerning support services, treatment options, and advantages and disadvantages. Health and medical practitioners are likewise required familiarizing themselves regarding clinical and research data for development of individualized rationale for treatment approach specific for individual clients.
The rationale serves as basis for use of interventions or treatments for people with PTSD. According to research results, genes play a role in creating fear memories (National Institute of Health, 2014). Medical practitioners need enough competence in diagnosing the other conditions linked with PTSD. Ensuring their capacity making diagnosis and treatment legally and professionally specific to clients’ conditions and experiences is one. Further, practitioners’ background in this mental health discipline should be evident in the way they assist clients in competent manner as they work through traumatic re-experiencing, side effects, and other symptoms prior to any treatment.
E. Research Technologies
Practitioners well-trained in research technologies such as neurofeedbacking should underscore successful intervention to minimize the anxiety and depression among patients with this particular anxiety disorder. Because the patient has abnormal hormonal level and hyper-arousal of their neural system, they relive traumatic scenarios. Biofeedbacking, (e.g., relaxation training), is another treatment option for individuals with posttraumatic stress disorder. Patients are taught on how to feel comfortable and relax combined with associated techniques (e.g., guided imagery),which is a recreated outlook will help and assist them to learn on how to overcome disruptions and incapacity in life.
F. Medication and Medical Treatments
Chemoprophylaxis and pharmacotherapy (e.g., selective-serotonin reuptake inhibitor), for individuals with post-traumatic stress disorder, prevent its potential recurrence and development (Li-Ming, et al. 2012). There are various medication in use for the prevention of PTSD, including but not limited to alcohol, propanolol, morphine, and cortisol.
For centuries, alcohol use prevent stress. Intoxicated individuals feel its protective effect, such as minimizing the likelihood of reliving PTSD. Alcohol is not only cheap and readily available, but because of its social acceptab. Nevertheless, its disadvantage include high alcohol consumption that renders alcohol not appropriate for prophylaxis in always preventing PTSD. Moreover, alcohol is among the five main causes of disabilities worldwide.
Other than alcohol, propanol helps in the prevention of the recurrence of PTSD symptoms, such as avoidance, re-experiencing, numbing, hypervigilance, and startling). However, it effectiveness in preventing PTSD does not provide compelling evidence. Then, there is morphine. Armies sent for the Gulf War were given morphine so that they less likely develop PTSD. Even among vehicular accident victims, high morphine dosage will more likely protect them against the re-experiecing the trauma. Last only in this list is cortisol. Septic shock and cardiac surgery survivors, when administered with hydrocortisone, are less likely to develop the anxiety disorder. Other drugs being used include sertraline, paroxetine, amitriptyline, venlafaxine, among others .
The timing and legal ramification of chemoprophylaxis and pharmacotherapy raise some concerns . It has been suggested that additional empirical and clinical research should be made in these and other areas.
G. Cultural and Other Contributory Factors:
Cultural differences and related contributory factors in appraising the influence of traumatic situations on individuals with PTSD are many. The anxiety disorder among survivors is much more pronounced and prevalent among independent cultures compared to interdependent cultures. The difference lies in view of self, control and agency (e.g., permanent change, mental defeat, and control strategies). The reverse of it is likewise true when the appraisal of taumas is focused on self relative to other people within or outside one’s culture, alienation, or interdependence.
Jobson and O'Kearney (2009) included respondents’ trauma history, trauma narratives, demographics, and depression. Each narrative was analyzed based on the participants’ experiences of torture, death in the family, kidnapping, serious accidents, natural disasters, mental illness, child abuse, and sexual assaults.. They showed that an independent culture is less likely recall traumatic memories compared with interdependent cultures. Regarding permanent change, alienation, control strategies, and mental defeat, Jobson and O'Kearney likewise found out the insignificant differences between independent cultures and interdependent cultures. Nevertheless, trauma survivors from the independent cultures were more alienatedwith permanent change, less regulating strategies, and with mental defeat compared to non-PTSD respondents from the other cultures. Additionally, individuals with PTSD were more alienated and had less appraisal than people without PTSD.
The research findings mentioned above also revealed the theoretical and clinical implications cultural differences and relationships between appraisals and psychological adjustments. People with high level of depression, panic and anxiety attacks are more prone to acquiring PTSD. The root causes of PTSD, nonetheless, has yet to be addressed. Although psychiatric and medical communities bring therapeutic and pharmaceuticals solutions and alternatives to help in the prevention, alleviation and treatment of the disorder, underlying issues and concerns remain unresolved.
Too much panic, depression, and anxiety are bad for individuals. Many people suffer who persistently cling on their negative thoughts and emotions as if they could not live without the symptoms of post-traumatic stress syndrome.
H. Personal Insights:
Posttraumatic stress disorder is mostly related to extremely traumatic scenarios or horrifying battlefield experiences. People, such as abused children, soldiers and other individuals, can suffer and later on have difficulty forgetting traumatic events (for example, tortured, gunned down, molested). Even though the experience was over, people recall vivid flashbacks in the form of nightmares about their past threatening or cruel encounters. They have hard time controlling, managing or regulating their emotions.
I have seen myself some individuals, mostly war veterans, who have PTSD. They easily get frustrated for no obvious reasons. They also manifest mood swings and other unusual feelings. Some of their atypical mental reactivity includes the inability to focus on task. Additionally, they think about dying, loss and death. Likewise, they make self-criticism and they decide impulsively. Moreover, they manifest behavioral reactions not limited to substance abuse, compulsive behavior, and decreased affection. Nevertheless, with familial and social emotional support, they still manage to alleviate their feelings of the anxiety disorder.
In some cases, there are instances wherein people can distinguish between individuals who display anxiety but within the normal range and other people who do not have PTSD in their mental health or medical history. Some people may actually suffering PTSD whereas other are merely experiencing psychosomatic disorders (that is, illness caused by their own subjective feelings and thoughts with undue attribution to signs and symptoms, causes, diagnosis, treatments, and living with PTSD).
Section III: Conclusion
Research findings have shown that PTSD is a ubiquitous phenomenon. Accounts on PTSD date back before human recorded history. There are also many candidate causes of the disorder, including but not limited to wartimes, sexual abuse, robbery, terrorism, natural disasters, accidents, and serious illness.
The anxiety disorder was evident initially during wars because soldiers and other people who experienced extreme abuses, tortures, attacks, and brutalities. Even in everyday occurrences, individuals can be exposed to the various risks of PTSD. In addition, people who have history of mental health illness, high levels of anxiety and depressions, brain injury, abused childhood, and other causes could suffer from PTSD.
Some preventive measures and treatments against PTSD are many, including but not limited to chemoprophylaxis and pharmacotherapy , psychiatric or psychotherapy counseling, emotional support, and medication. To date, however, there is still further need for empirical studies about PTSD for its prevention, recurrence, and long-term effects with people.
PTSD, as stated previously, is a worldwide phenomenon, thus, knows no age, gender, ethnicity, and boundaries. People with various degree of acquiring PTSD, despite their differences, have various ways of adaptive strategies to abrupt changes, mental perspectives, control strategies, or simply appraisals in view of individuality and/or relationships with other individuals.
References
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Jobson, L., & O'Kearney, R. (2009). Impact of cultural differences in self on cognitive appraisals in posttraumatic stress disorder. Behavioural and Cognitive Psychotherapy, 37(3), 249-266. doi:10.1017/S135246580900527X
Kilbourne, B., & Kilbourne, S. (2011). PTSD, Neurotransmitter Dysregulation and Reset Degradation Theory. International Journal of Interdisciplinary Social Sciences, 5(11), 139-152
Li-Ming, Z., Jia-Zhi, Y., Yang, L., Kai, L., Hong-Xia, C., You-Zhi, Z., & Yun-Feng, L. (2012). Anxiolytic Effects of Flavonoids in Animal Models of Posttraumatic Stress Disorder. Evidence-Based Complementary & Alternative Medicine, 1-10. doi:10.1155/2012/623753
National Institute of Health. (2014). What is PTSD. Retrieved from http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
Pace, T. W., & Heim, C. M. (2011). A short review on the psychoneuroimmunology of posttraumatic stress disorder: From risk factors to medical comorbidities. Brain, Behavior & Immunity, 25(1), 6-13. doi:10.1016/j.bbi.2010.10.003
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