Post-Traumatic Stress Syndrome
Introduction
In life, the possibility of witnessing or enduring a stressful event or circumstance such as the lose of a close friend (or relative), death of a family member, sexual abuse, or physical assault cannot be understated. Every passing day, such undesirable phenomena happen to a plethora of people and the effect of such occurrences is not uniform. To some people, such are normal order of the day hence have become accustomed to such occurrences. To others, the experience with such occurrences may be traumatic. As Krippner, Pitchford & Davies (2012) reports, the word trauma has its origin in the late 17th Century and was derived from the Greek for “wound”. This means, that for people who are not able to cope proficiently with traumatic events, the wound caused by the event might live to affect their lives probably for a lifetime. Post traumatic stress disorder is a psychological disorder with a straight-forward definition and known symptoms besides being treatable.
Definition and Symptoms of PTSD
The meaning of Post Traumatic Stress Disorder can be clearly understood with the understanding of the meaning of trauma. According to Beckner & Arden (2008), trauma involves facing a severe threat in which ones life is usually threatened even though in may at times comes as a result of witnessing a traumatic event happen to another person. There are several types of trauma; natural trauma (that are caused by natural disasters), unintentional traumas (that are majorly characterized by accidents for instance an explosion) and intentional traumas (that perhaps the most tragic and include events like rape and physical abuse) (Beckner & Arden, 2008). Beckner & Arden (2008) are keen to note that the interpretation of trauma is the most crucial determining factor with regards to a person’s ability to cope with the event. It should also be noted that traumatic experiences together with their aftermaths are by all means very difficult to delineate with accuracy (Krippner, Pitchford & Davies, 2012).
Post Traumatic Stress Disorder is an anxiety disorder that people suffer from as a result of being exposed to a dangerous or stressful event that is likely to distress any individual. Following a trauma, most people are likely to develop a fear of the event, have physical difficulties besides being emotionally numb and depressed (Beckner & Arden, 2008). According to the National Center for PSTD, there are five types of PSTD namely; normal stress response, comorbid PSTD, acute stress disorder, Complex PSTD and Uncomplicated PSTD (PTSD Network, 2012). Normal stress response is a type of response to stress that occurs to health individuals who have been exposed to a single traumatic event (PTSD Network, 2012). The most important feature of this type of PSTD is that victims always recuperate fully after a span of one week (PTSD Network, 2012). Acute stress disorder is yet another type of PSTD that is mainly characterized by panic and mental confusion and at time insomnia and lack of ability to handle relationship issues and activities. This type of PSTD does not commonly affect people who have suffered a single trauma but can result when the single trauma is very serious (PTSD Network, 2012). Uncomplicated PSTD, unlike Normal stress response and acute stress disorder, comes are result of persistent exposure to traumatic situations (PTSD Network, 2012). And while Comorbid PSTD, which is much more common compared to uncomplicated PSTD, is associated with other psychiatric disorders, complex PTSD is an overly serious type of PTSD that comes as a result of a prolonged exposure to traumatic situations. Prolonged sexual abuse during childhood is an example of such situations that most commonly result to complex PTSD (PTSD Network, 2012).
Krippner, Pitchford & Davies (2012), while citing the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (4th Edition) text Revision, assert that PTS has three main clusters of symptoms. The first cluster encompass intrusive memories that a person harbors as a result of re-experiencing the aspects of the traumatic situation in real life or even in sleep. The second cluster samples the emotional numbing that comes as a result of a traumatic experience. In this cluster, an individual displays symptoms such as avoidance of everything that is related to the traumatic experience. The third cluster as highlighted by Krippner, Pitchford & Davies (2012) relates to the hyper-arousal and nervousness characterized by lack of concentration, psychosomatic disorders, and startle responses.
Prevalance of PTSD
Riba, Wulsin & Rubenfire (2012) while assessing the effect of PTSD in patients with heart problems notes that most researches on PTSD have come to the realization that about 7% people in the world will experience PTSD at some point in their lifetime. Notably most people often display PTSD symptoms immediately after the occurrence of a traumatizing event but the prevalence and severity of the PTSD subside gradually with time. The rate at which the symptoms of PTSD subside is reportedly highest in the first few months after the occurrence of the PTSD-causing event.
Beck and Sloan (2012) on their part notes that the prevalence of PTSD cannot be accurately pinpointed due to multiple reasons such as trauma type, degree of exposure, and age, among other factors. Citing Faribank (2008), Beck and Sloan (2012) contend that the prevalence of PTSD in youths ranged between 0.5% and 10% even though this might differ from community to community. The authors also go ahead to compare the prevalence of PTSD in youth by disaster type whereby they state that the PTSD in youths exposed to natural disasters and acts of terrorism as overly common within the first few months of the occurrence of such traumatic events. For instance, three months after the occurrence of Hurricane, a whooping 55% of children surveyed reported having symptoms that relate to PTSD while close to 90% admitted to re-experiencing at least a single symptom (Beck and Sloan, 2012). Moreover, the national Centre for PTSD states that the prevalence of PTSD in adults is about 8%. Assertively, about 10% of adult men are most likely to suffer from PTSD compared to 5% female adults. This is so considering that men are at high risk of being exposed to traumatic events compared to women. Nonetheless, a male adult will have a 1 in 12 chances of suffering from PTSD compared to women who have a 1 in 5 chances of suffering from PTSD.
On the same note, empirical researches aimed at finding answers to questions like how men and women differ in terms of the prevalence of PTSD found out that there are elevated rates of PTSD in women compared to men based on generalized conclusions about how the biological and environmental differences vary between men and women. One of the commonly documented reasons is that men and women differ significantly in terms of exposure to traumatic situations; this assertion, from a personal stand point, is complex to understand considering that men are basically exposed to traumatic situations compare to women. To try and clear this discrepancy, researchers always try to make their explanations the basis of the sex differences between men and women as well as embracing controlled comparisons approaches. These approaches include the biological basis of men and women, social roles and cognitive styles. In should be noted, however, that PTSD, unlike most other psychological disorders, does not discriminate on gender age or ethnicity; any individual can develop PTSD.
It is also worthwhile noting that the relationship between PTSD and other disorders is complex (Brady, Back & Greenfield, 2009). However, PTSD share several symptoms with other psychiatric disorders such as depression and anxiety disorders hence in many cases, wrong diagnosis is always given whenever such symptoms are presented by patients (Brady, Back & Greenfield, 2009).
Risk factors for PTSD
As mentioned in the preceding section, anyone can develop PTSD. However, there are certain factors that make one to be more likely to develop the disorder more than others. Several studies have been carried out in an attempt to pinpoint the risk factors that influence the preponderance of PTSD. As Halligan & Yehuda (n.d) aptly state, the study of the risk factors associated with PTSD has become increasingly common with a plethora of the studies identifying biological, cognitive, personality and psychiatric history together with demographic, environmental and dissociation factors as being some of the major risk factors of PTSD.
Environmental risk factors relate to the factors such as family instability, living is a disaster prone area, and living in an insecure town. People living in an insecure town, for instance, are more likely to witness or endure traumatic events like the killing of a close friend by thugs, hence are more likely to suffer from PTSD compared to people living in relatively secure towns. Demographic factors, on the other hand, majorly relates to the gender issue. Halligan & Yehuda (n.d) contend that PTSD is indeed more prevalent in women compared to men. As mentioned earlier, scientists have not been able to aptly explain why women are more prone to PTSD. However, Halligan & Yehuda (n.d) cite other research findings in which the researchers concluded that females are more vulnerable to PTSD due to their vulnerability to assaultive violence which are in most case perpetrated by males. The assaultive violence referred to by these researchers encompassed rape and physical assault. It can also be asserted that the level of education, as a demographic factor, also role-plays in the causation of PTSD; people with low levels of education are more likely to experience PTSD compared to relatively educated people (Halligan & Yehuda, n.d).
As noted by Halligan & Yehuda (n.d), personality and psychiatric history have a close relationship with PTSD. This is because, several psychological and psychiatric disorders, inclusive of PTSD, have always been linked to personality and psychiatric history. This renders personality and psychiatric history to be a risk factor with regards to PTSD. Additionally, Halligan & Yehuda (n.d) report that peri-traumatic dissociation is a risk factor associated with PTSD. Most PTSD patients have always been found to have elevated scores when measured for dissociative symptoms. In a similar manner, the intellectual functioning of an individual is yet another risk factor that Halligan & Yehuda (n.d) refer to as cognitive risk factors. To prove this, Halligan & Yehuda (n.d) cite Macklin et al’s (1998) study in which they assessed the IQ of soldiers before combat and analyzing their IQ relative to the development of PTSD after combat. The researchers found out that more soldiers with lower IQs developed PTSD compared to soldiers with higher IQs. This led to the conclusion that intelligence levels have a role to play in the development of PTSD. Biological and genetic factors are also in the list of some of the most prominent risk factors in the development of PTSD. Several abnormalities that relate to pathophysiology of PTSD can be identified in patients of PTSD (Halligan & Yehuda, n.d). In one study, researchers found out that children born of parents who have suffered traumatic experiences had reduced levels of cortisol (an hormone produced by the adrenal gland in response to stress) compared to children born of parents with no any significant past traumatic experience (Halligan & Yehuda, n.d). With regards to genetic risk factors, several researcher give insight to the possibility PTSD being transmitted along familial lines; PTSD prevalence in monozygotic twins born of parent with a history of PTSD clearly shows that genes have a role to play as risk factors in the causation of PTSD (Halligan & Yehuda, n.d).
Treatment options for PTSD
Treatment approaches for PTSD acknowledge the fact that the disorder is a complex and dynamic entity and not just a unidimensional set of symptoms. The United States National Center for PTSD acknowledges that there are several sound treatment options for PTSD (National Center for PTSD, 2012). One such treatment option is the Cognitive Behavioral therapy which is perhaps the most formidable treatment option for PTSD and is normally offered in two forms; Cognitive Processing Therapy and Prolonged Exposure Therapy. Ideally, this treatment method aims at helping a PTSD patient replace the traumatic thoughts with thoughts that are less traumatic; basically, the treatment methods attempts to help the patient understand that he or she could not control anything that happened hence does not have to blame him or herself for whatever happened (National Center for PTSD, 2012). Additionally, PTSD can be treated through medication; antidepressants such as Celexa, Fluoxetine and Zoloft (National Center for PTSD, 2012). Other treatment methods include group therapy in which people with similar traumatic experiences share out in a bid to become more comfortable with the experiences, and family therapy whereby the whole family is involved in a counseling session moderated by a therapist in an attempt to foster good relationship between family members (National Center for PTSD, 2012). It bears to note that most of these therapeutic models last between three to six months even though there are some that can go up to a year (National Center for PTSD, 2012).
Conclusion
Concisely, Post traumatic stress disorder is a psychological disorder with a straight-forward definition and known symptoms besides being treatable. The disorder can be defines as an anxiety disorder that people suffer from as a result of being exposed to dangerous or stressful event that is likely to distress any individual and can be categorized into five type namely; PSTD namely; normal stress response, comorbid PSTD, acute stress disorder, Complex PSTD and Uncomplicated PSTD. PTSD is commonly expressed symptomatically with three clusters of symptoms. Additionally, several studies contend that biological, cognitive, personality and psychiatric history together with demographic, environmental and dissociation factors the most common risk factors associated with PTSD. Notwithstanding, the disorder can be treated with cognitive behavioral therapy, antidepressants such as Zoloft, group therapy and family therapy.
References
Beck, J. G., & Sloan, D. M. (2012). The Oxford handbook of traumatic stress disorders. Oxford: Oxford University Press.
Beckner, V. L., & Arden, J. B. (2008). Conquering post-traumatic stress disorder: The newest techniques for overcoming symptoms, regaining hope, and getting your life back. Beverly, Mass: Fair Winds Press.
Brady, K., Back, S. E., & Greenfield, S. F. (2009). Women and addiction: A comprehensive handbook. New York: Guilford Press.
Halligan, S. L., & Yehuda, R. (n.d). Risk Factors for Posttraumatic Stress Disorder. New York, NY: Department of Psychiatry, Mount Sinai School of Medicine.
Krippner, S., Pitchford, D. B., & Davies, J. (2012). Post-traumatic stress disorder. Santa Barbara, California: Greenwood.
National Center for PTSD, N. C. (n.d.). Treatment of PTSD - National Center for PTSD. National Center for PTSD. Retrieved November 17, 2012, from http://www.ptsd.va.gov/public/pages/treatment-ptsd.asp
PTSD, N. (2012). Types of PTSD. Psych Central. Retrieved on November 17, 2012, from http://psychcentral.com/lib/2006/types-of-ptsd/
Riba, M. B., Wulsin, L. R., & Rubenfire, M. (2012). Psychiatry and heart disease: The mind, brain, and heart. Chichester, West Sussex, UK: Wiley-Blackwell.
