Introduction
Most of the individuals of all ages experience at least one traumatic event in their life, which is followed by the wide range of reactions (Greenberg, Brooks and Dunn, 2015, p.1). Most researchers however claim that it affects women more as compared to their male counterparts (Sumner et al, 2015). Though post-trauma reactions appeared in literature throughout history, in last year’s numerous scientists and researchers began investigating various effects of traumatic experiences that may have significant influence on mental and physical health. This paper is focused on a relatively new diagnosis called Post-traumatic stress disorder (PTSD) which is defined as a mental health problem caused by witnessing or experiencing a traumatic event. It is a psychological response to unexpected uncontrolled events that may expose one's life to danger (Weinmeyer, 2015, p. 547).
PTSD is characterized be several types of symptoms: re-experiencing which includes repeating traumatic event in memory, nightmares and frightening thought. Avoidance, which means staying away from places, objects, memories and other reminders concerning tragic experience; numbing symptoms, feeling of guilt, loss of interest; hyper-arousal symptoms which cause emotional tense, anger, poor concentration, problems with sleep and control of emotions.Indeed, these symptoms can appear either in a week or even in several years after the trauma and may reveal themselves in different ways depending from person to person. It is a norm when survivors experience some symptoms after the dangerous event but when they last more than several weeks it becomes a health problem, which may lead to severe consequences.
As it was already mentioned PTSD can appear at any age as a result of such events as a natural disaster, car accidents, physical or sexual assault, death or military operations. Many people who had gone through such a threatening experience come back to their usual life for some time while others can face with numerous complications that interrupt normal life and habitual activities. It is possible to distinguish certain risk factors which also play role in whether an individual develops symptoms of PTSD: previous occurrence of mental illnesses, living through dangerous situation, being injured or seeing somebody killed or hurt, lasting or very severe trauma, poor social relations and lack of support, extra stress connected with the event such as loss of close person or loss of job.
There are also categories of people who are at higher risk of developing this mental disorder, for example, veterans of war and workers of law enforcement. In particular, initially, PTSD became the focus of numerous researches due to problems that Vietnam veterans faced when they tried to return to civilian life. "About 30% of the men and women who served in Vietnam experience PTSD" (VA National Center for PTSD). It was noticed that veterans developed common symptoms though they went through different combat situations. Empirical analyzes and studies were conducted which led to the conclusion that traumatic events may cause post-traumatic stress disorder.
According to the VA National Center for PTSD, “about 8% of men and 20% of women develop PTSD after a trauma and roughly 30% of these individuals develop a chronic form that continues throughout their lifetime". The course of PTSD is different from person to person and may change throughout time; sometimes there are periods when symptoms increase or decrease.
Along with numerous symptoms inherent for PTSD, the untreated mental disorder may have an extremely significant influence on various aspects of person's life and it is accompanied by many neurobiological and physiological changes. The most common conditions that follow PTSD include depressive disorders, anxiety, addiction to drugs and alcohol, unemployment, family disagreements and increased cases of violence.
Returning to the history of PTSD, it is possible to notice that Shakespeare's Henry IV and other heroes from the literature met many diagnostic criteria for this disorder. Though the first introduction was questionable, it represented the fundamental principles concerning nature of PTSD and viewed the concept of "trauma" at the core of the scientific approach to the problem. A large breakthrough has been particularly significant in the area of psychiatric theory and practice.
Previously, traumatic events were understood outside the ordinary human experience and were separated from natural life incidents such as severe diseases, divorce, loss of a close person, financial problems, etc. Such beliefs were caused by the assumptions that when facing a traumatic stressor, people show lower coping skills and elasticity than when they go through ordinary stress.
PTSD can be diagnosed only in cases when a patient had experienced a situation that is considered to be traumatic from his point of view. It is necessary to admit that trauma is not only external phenomenon, but it also undergoes cognitive and emotional processes which give signals of extraordinary threat. Such processes have significant individual distinctions that explain why different people have different trauma thresholds and develop different reactions to experienced trauma.
The disorder results from a person witnessing a traumatizing event. One which could be life threatening to them. It has the potential of inhibiting and changing the normal lives of the victim. The American Psychiatric Association listed it as one of the mental problems in 1980 in their third edition of standard diagnosis criteria (DSM-iv). Since then medical professionals to try to help people get through such difficult times as well as treat those who have difficulty in recovery have used it.
Development of PTSD
The chronic and complex nature of this disorder has been reported to be a source of substantial distress, which eventually tends to have a negative implication in a person’s social and personal functioning. Research by Xue, Ge, Tang, Liu, Kang, Wang and Zhang (2015, p.3) explains that PTSD is rampant in individuals who have served in the military. The study conducted by these authors seems to be supported by reliable sources because the information was derived from reliable sources such as PsycINFO, PubMed, and Embase. These sites provided them with observational studies, which is crucial for this empirical research. Their method of gathering information from the sources incorporated retrospective and cross-sectional data considerations and included the cohort studies. They utilized 32 articles for the literature review and data extraction after the study selection, a process which was conducted independently by differently for valid results (2015, p. 5).
For this study, specific PTSD predictors had to be selected such as stress in their lives, the severity of the trauma, abuse in their childhood and lack of social support as the main ones. The total number of predictors used was 18, which were deemed to be effective when used in the veterans and other military personnel. An advantage that this research including stemming factors was bound to affect the severity of the PTSD. Some of the factors are specialization in combat, the female gender, minority status of the ethnicity and low education among others. The key elements that were however expected to increase the chances of developing PTSD were the duration of the deployment and exposure, weapons at discharge and an actual event that involved the service member witnessing a killing or severe injury occurrence. After the application of these techniques, the study revealed that the prevalence rate of the PTSD that was combat-related was around 1.09% - 34.84% (2015, p. 9). It is important to note that the lack of support after deployment was a critical contributor to the development of PTSD in this plight. This article has provided enough evidence to reveal the valid risk factors that may affect the military personnel and lead to combat-related PTSD. There are gaps that were identified by these authors, and it acknowledged that more research was needed to determine the interaction between the variables discussed and the determination of the best way to prevent the occurrence of PTSD to reduce susceptibility.
Smid et al., (2015), whose study was meant to develop a kind of treatment that would mitigate the risk of PSTD occurring in people, conducted an alternative study. The treatment would combine interventions and focus on the type of PTSD associated with grief. This study combined the study of PTSD and persistent complex bereavement disorder (PCBD), as well as the major depressive disorder (MDD), as the main disorders that may arise after traumatic grief (2015, p. 1). Unlike the article by Xueet al., (2015), which focused on the military staff, this one chose to engage people of different cultures and how they are affected by traumatic grief. Their method applied in gathering the data for the study was the application of the traumatic grief cognitive stress model, supported by evidence-based treatments for the patients and came up with the brief eclectic psychotherapy for traumatic grief (BEP-TG) as the treatment for the disorder (2015, p. 5). Smid et al.’s study reveal that traumatic grief can be caused by specific triggers and exposure that is focused, among others. They then conclude that BEP-TG is a tailored solution to the PTSD treatment that can address the cultural differences in those who suffer from it. The gap identified in this case was that the studies conducted so far have ignored PTSD that is caused by traumatic grief.
These two studies were connected by the next study, which was conducted by Perrin et al., (2014, p. 447), who took a general population for their study, unlike Smid et al (2015) who focused on cultural factors, and Xue et al., (2015), who chose the military staff.Perrin et al., (2014, p. 448) targeted to explore the causes of the disorder and applied. The Diagnostic interview for genetic studies and conducted in on a random sample to get the general population that had been targeted. Their sample size seemed to be an adequate representation considering the number was 3691. The results showed that the chances of someone developing PTSD were 5%, with a higher prevalence in the female population even if the conditions remained the same (2014, p. 452). The author’s research also revealed that sexual abuse was the highest trigger of PTSD, followed by the preexistence of the bipolar disorder and neuroticism. The other significant triggers were alcohol dependence, being a previous victim of crime or violence witness, and anxiety disorder (Perrin et al., 2014, p. 449). The gaps identified were that future studies needed to consider focusing on the subjects as early as in adolescence to determine how early the PTSD can be manifested after experiencing a traumatic event.
In the third criteria, the event was described to be one that was beyond the usual range of human experiences. This definition was not for normal stressors such as ill health, divorce, and separation from spouse or loss of things such as pets and jobs. It had to be something that was not usual for example, military officers sent to war zones, rape, torture and other disasters like earthquakes. Social exchange theory asserts that human beings engage in a cost-benefit analysis before they engage in relationships (Cohen, 2015). They gauge the outcomes and only get into those that they gain something in return. When engaging in the relationships, human beings will look for alternatives for the choice that they have. The reasons it asserts include direct reward, to develop a reputation, to influence others and because they anticipate that others would do the same for them. Other people engage in social exchange due to altruism or a perfection of efficacy. The aspect explains PTSD.
In the year 1994, APA updated the list of potential events that could be classified as stressors that can cause PTSD I criteria IV. In this definition, the person had to go through a game that left them feeling helpless, in fear and horror (Greenberg et al., 2015). The difference, however, that this criterion has is that it does not take into consideration the reactions of people after the event. In a study does after the bombing in Madrid, the results concluded that the patients that were treated with injuries from the terror attack had more symptoms of developing PTSD than the police officers that attended and went through the experience. Despite the fact that the police officer has had to deal with the aftermath of many incidents, they still gave fewer symptoms in the study.
Friedman discusses the inclusion of the DSM-5 in the criteria, which he says, that is broader than the third and fourth edition. It includes all the changes that the practitioners felt needed to be added, deducted or modified from the previous sets. Studies have been done which give evidence-based suggestion for any changes made (2015).
According to Greenberg et al., not all the people that go through tough times are going to develop PTSD. They explain that the post-event environment of the victims determines their chances of developing the problem or not (2015). Those who receive adequate debrief and counselling at the time the event has happened has a better chance of recovering and going back to sanity. That translates to the rest who will not receive any immediate help developing the disorder.
Many young and senior citizens have been sending to the battlefield for many years. Some die atwar, and others return home wounded. They end up reliving instances that happened at the time of war. They get dreams and nightmares, and therefore they get prolonged durations of psychological disturbance (Marston and Kopicki, 2015). The solution that has been set for them is that currently they can use service dogs to help them. They have the ability to address the social, biological psychological perspectives of the patient. Their interaction made it easy for the officers and especially the veterans who are old and retired from active service.
Data collection
Patient that were admitted and treated for the disease have a good prognosis and their integration into the community befitting. They can continue living their lives well although some may have to rely on treatment for longer durations than others do. Wang, Woo did a study, and Bahk, (2015), stated that patients, who recover, feel that they do not have reasons to continue taking their treatment, and therefore, they default. When discharged from the hospital most of them do not go on to book for future outpatient appointments with their doctors. This situation makes it difficult for the physician to monitor progress and therefore, increase the chances of such patients having a future relapse of the condition. The amount of time that the patient spends in admission is also an influential factor on how willing the patients will be to continue treatment.
Children who develop this disorder have a major challenge. Most of the caretakers that bring the children to the health facility do not just come seeking how to help the child get through the stressful situation. They need help to get the child to leave some distractive behaviors that they have. Most of the parents do not necessarily think that their child could be having mental problems (Cohen, 2015). The studies done on children prove that they do not get much help from medical therapy. The best management for them is therapy where they get face-face conversations with the counsellor. They can talk about their problems and get help in how to deal with such in future. The practical scenario of this is the family level. Most of the families may have differences but they eventually read from the same page (Ogburn, 2015).
Analysis
A more appropriate method that can be used for the management of this condition is prevention. In the estimation given for development of PTSD, (Ogburn, 2015), people that go through stressful situations, 10-20% develop a problem. Of that number 50% recover without having medical attention. 10-20% of them seek treatment, but their prognosis is not good because they go on and develop chronic PTSD. Modern technology has been studied to help in the quick recovery of patients that develop this disease.
Discussion
A personal experience with the people who suffer abnormal psychology shows that they get the best of what is on offer at the It is important for the country to consider inclusion of preventive measures such as the introduction of preventive counseling in the health system.This will help to motivate people to seek help sooner than they normally do. Making report channels of communications open is a solution that can help in situations where victimization is a defacto (Greenberg et al., 2015). Many of the victims go unnoticed for a long time. The problem can be attributed to fear of the consequences that can be faced in case of publicity. In the case of military officers and especially those women that undergo stressful events such as rape have a fear of retribution from their superiors, and therefore they are slow to speak up. They may not speak at all until they get to chronic phases of their disease (Ogburn, 2015).
References
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Marston, H. & Kopicki, A. The Impact of Service Dogs on Posttraumatic Stress Disorder in the Veteran Population. The Military Psychologist. Division 19
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Sumner et al. (2015). Trauma Exposure and Post Traumatic Stress Disorder Symptoms Predict Onset of Cardiovascular Events in Women. Circulation AHA. Retrieved from http://circ.ahajournals.org/content/early/2015/06/23/CIRCULATIONAHA.114.01449 2
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