Introduction
Human beings have a certain threshold within which they can withstand stressful and traumatic situations. When this threshold is surpassed, then they develop psychiatric conditions. Post traumatic syndrome is one of the resultant problems in this case. In light of current research, physical abuse, emotional problems, child abuse, environmental toxins, extended combat and terrorism are some of the main causes of this syndrome. Post- traumatic stress disorder (PTSD) is a recurrent disorder. This is a syndrome that people develop after experiencing aberrantly distressing, traumatic and threatening events. This is a psychological issue that has been present in the world for a long time. Psychiatrists and psychologists have revealed a variety of treatments for this syndrome. Post traumatic stress syndrome is a resultant factor of exposure to a psychologically disturbing situation or event.
Overview of Post Traumatic Stress Syndrome
It is estimated that about eight million Americans are affected by this syndrome. Post-traumatic stress disorder or syndrome (PTSD) is a byzantine disorder accelerated by exposure to a highly traumatic and distressing event (Schester & Willheim, 2009). According to history, post traumatic stress syndrome first appeared in the year nineteen eighty. This was the time a lot of soldiers were returning from the Vietnam War. A lot of doctors experienced that these soldiers and some civilians were acting in a weird and in a non- diagnosable manner. This prompted further research on the syndrome depicted by the affected soldiers and civilians.
This research revealed that similar symptoms were experienced in other people who had experienced disturbing events such as natural disasters. The renewed interest also revealed that the syndrome was studied over a hundred years back. Back then, post traumatic stress syndrome was given a myriad of epithets. The names were sometimes synonymous to the prior event suggested to have caused the condition. For example, the syndrome was known as shell shock, railway spine, traumatic or war neurosis, rape- trauma syndrome and even concentration-camp syndrome (Schnurr, Friedman & Bernardy, 2009). The word syndrome here implies availability of a myriad of symptoms that could strongly suggest a number of diseases.
Currently, there is still no single definition of post traumatic stress disorder. A number of definitions have been unveiled by a variety of scholars. All these definitions are correct, and they point to one thing. The difference is that each consecutive definition is more refined than the last one. However, ideas are espoused from previous definitions and the symptoms. One of the most recent definitions is that from the Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-IV-TR). The authors state “the essential feature of post traumatic stress disorder is the development of characteristic symptoms following exposure to an extreme traumatic stressor” (The Association of Physicians, 2013, p.2). A simpler definition is given by Iribarren, Prolo & Chiappelli suggesting that post traumatic stress disorder is a resultant of one being under an event that is threatening and traumatic (2009).
The phrase ‘traumatic and threatening event’ has been used severally in these definitions. Such an event has to have specified characteristics. Iribarren, Prolo & Chiappelli insist that the event should be experienced directly by the affected person. The stressful situations in this case are characterized by threats to life, physical integrity or serious injury (2009). Witnessing or learning of an event that involves similar situations is likely to cause trauma. Usually, an individual reacts to such events by exhibiting fear and helplessness, and tries to avoid being reminded of it. Examples of real life traumatic events include violent assault, kidnapping and abduction, child abuse, terrorist attacks, military combat, torture and even disasters. In some cases, news of a chronic illness is likely to dispose one to post traumatic stress disorder.
Symptoms of Post Traumatic Stress Disorder
The symptoms fall under two categories; adult symptoms and childhood symptoms. According to Schnurr, Friedman and Bernady (2009), symptoms exhibited in children fall under seven principal categories. First, the child has problems with attachment, they lack trust form boundaries and prefer to be isolated. Their biological well being is interfered with as they have difficulties integrating sensory feelings. Thirdly, emotional expression and communication are difficult aspects in such children. The children also have impaired memory, impulsive behaviors, inability to pay attention, low self esteem and general pessimism of their bodies. This problem may continue through to adulthood. Adults’ exhibit symptoms such as; difficulty in regulating emotions, repression or forgetting traumatic events, shame and guilt, preoccupation with revenge, social isolation and a sense of helplessness.
Relationship of Post Traumatic Stress Disorder with Other Psychiatric Disorders
Research findings suggest that post traumatic stress disorder is highly related to other problems in the body. This syndrome predisposes one to other mental illnesses. This relation is of enormous significance. A survey done by Dubovsky (2011) revealed that at least eighty percent (80%) of individuals with post traumatic stress disorder are probable candidates of severe mental disorders. It is the post traumatic stress disorder that is likely to lead to the development of a severe mental illness. Further studies done by The Association of Physicians (2013) revealed that at least thirty six percent of patients suffering from post traumatic stress disorder develop obsessive compulsive disorder. Fifteen percent (15%) of them develop panic disorders. In the above cases, it is clear that post traumatic stress disorder predisposes patients to other mental illnesses.
Certain factors also predispose an individual to post traumatic stress disorder. Of all the patients seeking treatment for this syndrome, about eighty percent (80%) of them abuse alcohol and other substances. Sixty percent of them state instances where they were clinically and non- clinically depressed (Westgard, 2009). This is something they have been doing prior to diagnosis. About seventy five percent (75%) of all post traumatic stress disorder patients suffer from other diseases. Hypertension, ulcers, digestive diseases, bronchial asthma, and musculoskeletal problems are mostly associated with post traumatic stress disorders. The patients are said to be experiencing pain that makes them feel different, and thus they are likely to end up developing post traumatic stress disorder.
Another study done by Iribarren, Prolo & Chiappelli, (2009) suggest that about thirteen percent of patients with post traumatic stress disorder have a high severity of committing suicide. These findings are similar to those done by The Association of Physicians (2013). The association further insists that symptoms of post traumatic stress disorder vary with the causal effect, and also the environment the patient is found in. Chronic illnesses are highly likely to lead to the development of severe post traumatic stress disorder. This is not likely to change even with treatment. The situation is different when it comes to onetime events.
Who Is Most Likely To Develop Post Traumatic Stress Disorder?
Each individual has a specified threshold of overcoming traumatic experiences Dubovsky (2010) did a survey aimed at finding out the kind of individuals likely to be predisposed to post traumatic stress disorder. Apparently, a lot of factors come into play. First, certain genetic makeup is likely to make an individual highly susceptible to this syndrome. The environment and other factors also play an essential role in this case.
The findings of Dubovsky (2011) and Westgard (2009) suggest that women have more traumatic experiences than men. The natural ones include labor and delivery pain and even menstrual pain. Others are caused by unnatural acts such as rape, effects of war and a variety of sexual abuse. These factors cause women to be highly susceptible to post traumatic stress disorders. For example, pregnancy loss is one of the main causes of post traumatic stress. Men do not experience some of these factors; they are thus likely to develop this syndrome.
Genetically, women have more hormones than men. They are thus likely to react robustly to trauma. Their gender roles and culture allows them to react in this manner further compounding to this problem (The Association of Physicians, 2013). Moreover, women are usually exposed to the negative effects of traumatic situations like war. This affects them more than men especially since they are attached to their children. In this way, they handle more stress than men predisposing them to post traumatic stress disorder.
People from poor backgrounds are also exposed to factors that are likely to cause post traumatic stress syndrome. For example, children that grow up in poverty stricken backgrounds may lack proper medicine, parental care mostly because both parents are working and also toxic environments. However, Iribarren, Prolo & Chiappelli (2009) insist that such children are likely to handle the situation much better than those from affluent backgrounds. Reasons behind this allegation are still under investigation.
Risk Factors Associated with Post Traumatic Stress Syndrome
- Biological Factors
Dubovsky (2010) insists that the biological make up of an individual affects how well they respond to stress. This determines the rate at which they are likely to develop post traumatic stress disorder. Factors like sleeping, feeding and reproduction are controlled by the brain. Specifically, brain parts like hypothalamus, neuro- cortex and the limbic system are involved in this case. During extreme stress, endogenous stress hormones are produced by the brain. The hormone responsible for this activity is norepinephrine. In case too much of these hormones are produced, amnesia is the result. People who produce high amounts of these hormones are highly susceptible to post traumatic stress syndrome.
Some human beings are also capable of producing neutralizing hormones in extremely depressing situations. In this way, they are capable of handling stressful situations. However, in patients with post traumatic stress disorder, the production of such hormones is quite low. This is the causal factor behind depression that develops to post traumatic stress disorder. In a bid to deal with these feelings, such people are also likely to develop cravings for risky behavior like abusing drugs and alcohol. As stated above, this makes them susceptible to post traumatic stress disorder.
A large percentage of human beings experience situations that are likely to make them develop post traumatic stress disorder. However, a countable number of situations end up in this manner. Iribarren, Prolo & Chiappelli (2009) found it necessary to elucidate the reasons behind this. A number of findings suggest that some familial factors are likely to predispose an individual to such a condition. However, it is impossible to determine the specific generational lines within which the syndrome is likely to develop. This is because families share different environments, and they also keep moving from one direction to another.
The findings after an extensive research suggest that children are likely to develop post traumatic stress disorder. This is because children have a capability of storing memory for a long time. As such, children from families that experience traumatic effects are at a high risk of developing this syndrome (Dubovsky, 2011; The association of Physicians, 2013). The case is even severe when it comes to adult children owing to the fact that their level of understanding is advanced. Experience is the determining factor in this case.
- Social Factors
The social factors involved in post traumatic stress disorder are; exposure to war, terrorism, rape, incarceration, all forms of violence, environmental toxins, aggressive situations, sexual abuse, bullying and even peer pressure. Peer pressure is likely to lead one to abuse drugs like alcohol and cocaine. This is especially common among teenagers and young adults. Eventually, this may lead to addiction that drives one to depression. Depression is likely to develop to post traumatic stress disorder (Iribarren, Prolo & Chiappelli, 2009). Violence evokes feelings of panic and fear as a result of the threats. Bullying that happens in schools and other social places reduce the self esteem of an individual. Sometimes, this goes to greater extends making the individual to become anti- social. As such, the social environment plays a key role in the development of post traumatic stress disorder.
- Psychological Factors
In most cases, social and biological factors lead to the psychological factors that cause post traumatic stress disorder. Any form of stress is likely to affect the psychological well being of an individual. Normally, traumatic situations are the ones that cause stress. Overwhelming trauma results into psycho- emotional stress.
Hageman, Andersen & Jorgensen (2009) define psycho-emotional stress as lack of perception or loss of fit of abilities. In this case, an individual is incapable of satisfying their personal demands. A typical example is when a person lacks self esteem. They are incapable of feeling whole mainly because they cannot satisfy the demands of their inner world. This causes depression which leads to post traumatic stress disorder.
In some cases, the society magnifies the stress one is undergoing. A typical paragon includes abuses to a disabled child by giving them obscene epithets. It should be noted that being disabled due to an accident does not necessarily imply that an individual will be depressed. However, harassing or bullying of individuals who are experiencing stressful situations magnifies these problems. This causes psychological problems, which may later lead to post traumatic disorder.
Treatments for Post Traumatic Stress Syndrome
A variety of psychological and pharmacological treatments of post traumatic stress syndrome exist. These are able to effect significant reduction in distress and stress in an individual. However, a proper and appropriate diagnosis should be made if any treatment is expected to work. Therefore, a professional should be involved in this case.
Psychological debriefing is one of the interventions given to an individual. This kind of treatment is offered shortly or immediately after an individual experiences the traumatic event (Hageman, Andersen & Jorgensen, 2009). The main goal in this case is to prevent the development of feelings that will lead to post traumatic stress disorder. These reduce the psychological stress associated with this syndrome. Humanistic and psychodynamic interventions can also be applied.
Pharmacotherapy is also another approach employed to deal with post traumatic stress disorder. This is utilized at any stage of the treatment process. In most cases, combinations of psychotherapy and medication treatments are employed. Antidepressants like monoamine oxidase inhibitors, tricyclic antidepressants and serotonin reuptake inhibitors are some of the common medications. Anti- anxiety, mood stabilizers and adrenergic agents are included in this case. The in8 trauma technique is one of the most recent forms of treatment available. This is a quicker way of offering treatment. The treatment is applauded for not forcing patients to relieve the traumatic events. Instead, a lot of empathy is applied.
- American Psychiatric Association. (2007). Diagnostic and Statistical Manual of Mental Disorders. Third Edition. Washington: American Psychiatric Association.
This manual presents information on the different types of mental disorders. Post traumatic stress is listed herein, and more information is provided. This can be accessed from the American psychiatric association library.
- American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington: American Psychiatric Association.
This is a manual containing all the mental disorders in the world, their prevalence rates and causes. This can be accessed from the American psychiatric association library.
- Coates SW, Rosenthal JL, Schechter DS. (2009). Trauma and Human Bonds. Hillsdale: The Analytic Press.
This book presents information on treatments specific to all types of mental disorders.
- Sandro G., David V., Heidi R., Jennifer A., Ezra S., Joel G., Michael B., & Dean K. (2003). Trends of probable post traumatic stress disorder in New York after the September 11 attacks. American journal of epidemiology. 1(58), 95-102. http://141.213.232.243/bitstream/handle/2027.42/40325/Galea_Trends%20of%20Probable%20Post-Traumatic%20Stress_2003.pdf?sequence=2
Evidence for traumatic events as a causal factor in post traumatic stress disorder is provided in this article. The article also gives tentative treatment procedures offered.
- Stein MB, Walker JR, Hazen AL, Forde DR. (1997). Full and partial posttraumatic stress disorder: findings from a community survey. Am J Psychiatry. 154:1114–19.
The symptoms of post traumatic stress disorder are provided in this document. It can e accessed from the journal of psychiatry.
References
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Hageman, I., Andersen, H, S., & Jorgensen, M, B. (2009). Post-traumatic stress disorder: a review of psychobiology and pharmacotherapy. Acta Psychiatr Scand. 104, 411–22.
Iribarren, J., Prolo, P., & Chiappelli, F. (2009). Post-Traumatic Stress Disorder: Evidence-Based Research for the Third Millennium. Evidence based complementary and alternative medicine. 2(4), 503-512.
Schechter, D. S. & Willheim, E. (2009). Disturbances of Attachment and Parental Psychopathology in Early Childhood. Child and Adolescent Psychiatric Clinics of North America 18 (3): 665–686.
Schnurr P, P., Friedman, M, J., & Bernardy, N, C. (2009). Research on post-traumatic stress disorder: epidemiology, pathophysiology, and assessment. Journal of Clinical Psychology. 58, 877–889.
The association of physicians. (2013). Recognizing post traumatic stress disorder. Oxford journals. 97(1), 1-5.
Westgard, E. (2009). Coming home with post traumatic stress disorder. American journal of nursing. 109(5), 11-19.
