Post-Traumatic Stress Disorder

Jun 10, 2019 | 0 comments

Jun 10, 2019 | Miscellaneous | 0 comments

Biopsychological Analysis of Post-Traumatic Stress Disorder

Introduction

Post-traumatic stress disorder commonly referred to as PTSD is defined as a psychological disorder that affects people who have gone through an event or experience in life that was traumatic and life-changing (Poole, 2016). According to Poole (2016), PTSD symptoms are defined by these particular factors such as flashbacks, acute anxiety, as well as hyper-arousal-disrupt which affect the normal functioning of an individual. PTSD is however classified and defined as a psychological disorder, only recently research has expanded its efforts in attempting to comprehend PTSD’s bio-molecular root cause and origin (Poole, 2016).

This analysis will focus on the Biopsychological aspects of PTSD bringing an in-depth understanding of the cause of PTSD, indicators, and factors that influence the trigger of PTSD, the pathological perspective as well as the diagnostic, treatments, and research technologies of PTSD. I chose this particular topic due to a personal experience through PTSD research which widely included the vast studies of Veterans, as well as couples, families, and subgroups of Veterans which include various eras of veterans.

Definitions of PTSD

PTSD in various disciplines holds different definitions according to the various disciplines’ perspectives and scope. Galazyn (2015) defines PTSD from a neurological perspective. Galazyn (2015) states that despite the underlying biological aspects consisting in the protracted as well as immediate trauma-related responses which are significantly complex, with research going back forty years focused on mammals including humans which have brought forth a demonstration of trauma especially in trauma that occurs earlier in an individual’s life cycle; thus presenting neuron-chemical effects and responses on the long run to the stressful events (Harvey & Pauwels, 2013). The effects consist of the level magnitude in regards to the catecholamine responses together with the extent and duration of the emerging cortical responses. Moreover, the neurologists state that PTSD consists of the involvement of a substantial number of biological systems, which include mesolimbic brain structures together with a range of neurotransmitters.

In psychology, PTSD is popularly described as “shell shock.” Harvey and Pauwels (2013) mention that the psychological perspective of PTSD presents the disorder as anxiety associated with mental health disorder which emerges more often than not after a stressful event of extreme levels. Harvey and Pauwels (2013) state that the psychological comprehension of PTSD was expounded and acknowledged that PTSD occurs and emerges after the occurrence of a traumatic event, and as such does not present a sign of poor character or weakness in an individual’s character. Furthermore, in the year 1980 PTSD was officially acknowledged as amongst the types of mental health disorders (Harvey and Pauwels, 2013).

Furthermore, research has proven distinct differences in the neuropsychological functioning that occurs between both PTSD and the control participants. According to Poulson (2017), a deep interest in a focus in the neuropsychological functioning in regards to PTSD emerged as a response to the PTSD patients’ individual complaints of issues with attention, memory, as well as concentration. Poulson (2017) states that various studies in the past decade have recognized the significant reduction in the performance level of the verbal memory as well as the learning in participants in regards to PTSD control participants.

Epidemiology

Regel and Joseph (2017) point out that a Biopsychological analysis from a PSTD survey within a large and representative community which is based on a sample of twenty-four countries has an estimation of the PTSD conditional probability of traumatic events in twenty-nine forms. The epidemiology of research for a Biopsychological analysis includes 33% in violence that occurred in sexual relationships such as childhood sexual abuse, rape, and intimate partner violence; 30% in traumatic experiences due to interpersonal-network such as a loved one unexpected death, a child’s life-threatening illness and even any other traumatic event which involves loved ones; 12% in interpersonal violence such forms of childhood physical abuse, being witness to interpersonal violence, a threat by violence and physical abuse; 3% to being exposed to organized violence such as an experience as a refugee, kidnapped, and a civilian caught up in a war zone; 11% in organized violence participation such as combat exposure, being witness to serious injury and death including the discovery of dead bodies, purposefully caused injury and death; 12% in traumatic events that are life-threatening such as the collision of a motor vehicle, natural disaster, and exposure to toxic chemicals.

Signs and Symptoms of Post-Traumatic Stress Disorder

Astorga (2015) documents that PTSD symptoms are more likely than not to begin within the first month of a specific traumatic event, however, there are cases where the symptoms may delay and instead appear several years after the occurrence of the event. Astorga (2015) mentions that PTSD symptoms implicate significant issues within the social and work situations as well as in an individual’s relationships. Astorga (2015) further mentions that PTSD additionally interferes with one’s capability to carry out their day to day activities.

According to Galazyn (2015), PTSD symptoms are classified into four distinguished groups; avoidance, intrusive memories, mood and thinking negative changes, as well as substantial changes in emotional and physical reactions. Galazyn (2015) mentions that it is vital to note that symptoms more often than not vary from one individual to another.

Intrusive memories as a symptom include recurring unwanted distressing memories involving the traumatic events, flashbacks, nightmares involving the traumatic events, and severity in physical reactions as well as emotional distress to situations that are reminders of the entire traumatic event (Ford & Courtois, 2014). Avoidance is a key symptom involves; attempting to completely avoid talking and thinking of the traumatic event, attempting to completely avoid activities, places, as well as people which are reminders of traumatic events.

Ford and Courtois (2014) explain that mood and thinking negative changes as a symptom includes; a tendency of hopelessness in regards to the future, negativity in thoughts about the world, other individuals and self, memory issues, significant difficulty in maintenance of close relationships, a feeling of detachment from friends and family, no interest in the activities once previously enjoyed, a difficulty in experiencing positive emotions and a feeling emotional numbness.

Poulson (2017) states that changes in both emotional and physical reactions, which is also referred to as arousal symptoms include; easy startling, constantly being on guard looking out for danger, self-destruction behavior for instance over speeding or drinking, sleeping troubles, overwhelming shame or guilt, angry outbursts as well as irritability and aggressive behavior.

Poulson (2017) further states that for cases of PTSD of children who are of the ages of six and below the symptoms may include; re-enacting of aspects of traumatic events via play, and nightmares which more often than not consist of of of various aspects of traumatic events.

PTSD Subtypes

Individuals experiencing PTSD may have a number but not all of the PSTD symptoms; however, PTSD may not share a similarity. Thus, Ford and Courtois (2016) explain that there exist very specific PTSD subtypes that may affect some individuals. Ford and Courtois (2016) further explain that these particular subtypes may be perceived as implications of the PTSD illness; however, those individuals who may be experiencing these subtypes may require different therapies as well as treatments to get better.

Ford and Courtois (2016) suggest that there exists about five defined PTSD subtypes; these include victim-related trauma, natural-disaster trauma, survivor trauma, perpetrator guilt, and PTSD which is not specified. Victim related trauma involves individuals who were victims of a particular criminal attack or witnessed a criminal attack that more likely than not involves physical violence (Ford and Courtois, 2016). Natural-disaster trauma is less likely to because of human activities and is minimal and almost no control such as hurricanes, tornadoes, and earthquakes.

Survivor trauma more often than not is associated with one antagonist and one victim; however, the event at times has several victims and not only one. Moreover, there are cases when only one individual makes it a survivor of the incident (Ford and Courtois, 2016). Ford and Courtois (2016) indicate that perpetrator guilt involves feelings and thoughts of helplessness when facing fear, however, individuals within this particular subtype had a portion of involvements to the traumatizing event; either through planning or participation which follows a deep realization that was entirely a huge mistake. Alternatively, an individual may find themselves entirely caught up in that particular moment, and later making a realization of the error they made days or even months later (Ford and Courtois, 2016).

Lastly, Ford and Courtois (2013) expound that PTSD which is not specified involves traumatic events that may emerge from ripples which may affect individuals hours or even days after a particular issue has already gotten a resolution. Individuals who experience this particular are those who are involved in cleaning up after a natural disaster such as tornadoes, those who do the collection of bodies from the crime scenes, those involved in comforting rape victims, or those who end up listening to loved ones discussing traumatic events. Ford and Courtois (2016) explain that these individuals are not direct witnesses to traumatic events; however, they are significantly affected by events they may experience as an aftermath of the traumatic event.

Pathology behind PTSD

PTSD pathogenesis has no standard definition. Poulson (2017) points out that the imaging studies have made the indication that trauma, as well as long-term stress, has the capacity to result in functional changes within the neuro-anatomic structures together with the neural networks. Poulson (2017) expresses that an individual’s sympathetic nervous system, catecholamine system, hypothalamic-pituitary-adrenal axis, as well as 5-hydroxytryptamine system significantly vital for effective stress response, a mood-regulating, together with awakening during the evolution and occurrence of PTSD. Research studies investigate the relationship that exists between PTSD and the neurotransmitters which result in controversial implications of a patient’s injury upon their body not entirely excluded. Patients who suffer from mental trauma which is caused by PTSD with no physical trauma in avoidance of the interfering elements (Poulson, 2017).

Diagnosis

Diagnosis of PTSD involves a doctor’s performance of a physical examination to identify medical problems which may be the root cause of a patient’s symptoms. The doctor will carry out a psychological evaluation which is inclusive of a discussion into an individual’s signs and symptoms as well as the events that led to its trigger. Thirdly, the doctor utilizes the DSM-5 criteria which are an American Psychiatric Association publication.

Diagnostic Criteria

The PTSD diagnostic criteria have altered relatively due to the American Psychiatric Association’s most recent edition ‘Diagnostic and Statistical Manual of Mental Disorders (DSM-5)’ (In Martin, In Preedy & In Patel, 2016). First of all, criterion A presents exposure to either one or more events which associates with threatened death or death, threatened or really serious injury, or even a threatened sexual violation. Moreover, these occurrences faced an experience in either one or more ways mentioned: Experiencing the event, witnessing the event therefore not occurring to you but another individual, learning and gaining information about a situation that occurred to a close friend or a relative who went through a threatened or an actual violent or accidental death, and lastly, experiencing a consistency and repeated exposure to a set of distressing and vivid details of a traumatic situation, for instance, a police officer constantly having to face cases about situations of child sexual abuse.

Martin, In Preedy, and In Patel (2016) state that criterion B focuses on an experience of at least one of the intrusive symptoms which are associated with a particularly traumatic event; In Martin, In Preedy, and In Patel (2016) explain that the intrusive symptoms are expected or unexpected involuntary, reoccurring, as well as the intrusive memories that are upsetting of the particular traumatic event. Secondly, a sequence of consistent dreams that are upsetting which has the contents of the dream about a particularly traumatic event. Thirdly, an occurrence of a particular type of dissociation such as flashbacks to create a feeling of the traumatic event reoccurring. Moreover, persistent and strongly influenced distress with the exposure to specific cues that are inside as well as outside an individual’s body which are connected to the traumatic event in question. Lastly, In Martin, In Preedy & In Patel (2016) indicates that a substantially strong bodily reaction such as increased heart rate which occurs when one is exposed to any form of reminder of a traumatic situation in question.

Criterion C according to In Martin, In Preedy & Patel (2016) involves often occurrences of avoidance of reminders which concerns the traumatic event, thus including; avoiding feelings, thoughts, as well as physical sensations which trigger traumatic memories of a particular event, avoiding specific places, individuals, activities, objects, conversations, activities and even situations which trigger traumatic memories of a specific event (In Martin, In Preedy & In Patel, 2016).

Furthermore, criterion D involves at least three amongst certain negative changes within mood as well as thoughts which were an occurrence and even worsen the particular traumatic experience traumatic event: For starters the lack of ability to substantially remember any vital aspect in regards to the traumatic event in question (Adams et.al., 2013). Secondly, Adams et.al. (2013) point out that, the persistence as well as elevated negative evaluations which concern you as an individual, others, and the world as a whole; for instance a statement such as “I am unlovable.” Thirdly, an elevation of the blame of others and self-blame in regards to the consequence of causes of traumatic events in question. Moreover, an emotional state that is negative such as anger, shame, and even fear which is pervasive, a significant loss of interest levels in the activities which one used to enjoy, a substantial feeling of detachment from other people, as well as the lack of ability to essentially experience positive emotions such as joy, love, and happiness (Adams et.al,2013).

Adams et.al (2013) further points out that criterion Estates that at least three amongst the mentioned changes in regards to arousal which either worsened or started the traumatic experience event; aggressive or irritability in an individual’s behavior, self-destructive or impulsive behavior, a feeling of constant “on guard” such as danger lurking around an individual in every corner otherwise known as hypervigilance, a heightened and startle response, a substantial difficulty in concentration as well as sleeping problems (Adams et.al., 2013).

Furthermore, Adams et.al (2013) states that phase F which is also criterion F involves the symptoms mentioned above to persist for a time period of one month and more. Whereas criterion G consists of symptoms that exhibit considerable distress as well as substantially interfere significantly with quite a several various aspects of an individual’s life. Lastly, criterion H determines whether or not the defined symptoms are a result of other factors and not a medical condition and even a type of substance use.

Martin, In Preedy & In Patel (2016) states that the DSM-5 PTSD diagnosis requires one to attain the following factors; criterion A, in criterion B at least one symptom or more, in criterion C at least one symptom or more, in criterion C at least three symptoms or more, in criterion D at least three symptoms or more, and both criterion F and H. Martin, In Preedy, and In Patel (2016) further explain that there are two key specifications; the dissociative and delayed specification. Martin, In Preedy & Patel (2016) expounds that dissociative specification additionally to meeting the criteria for diagnosis, someone experiences a high level as a reaction to specifically trauma-related stimuli; first depersonalization which involves an experience of having a perspective of an outsider as well as detachment from oneself. Secondly, derealization which involves the experience of distance, unreality, or even distortion. On the other hand, delayed Specification consists of entire diagnostic criteria that remain not met till about a time period of six months or more after the traumatic event occurs, however, the symptoms on-set may occur almost immediately.

Treatment of Post-Traumatic Stress Disorder

Treatment of PTSD enables one to regain a substantial sense of control one has over their own life. PTSD’s primary treatment is essentially psychotherapy, although it also includes medication (Poole, 2016). Poole (2016) states that a combination of these treatments enhances the improvement of one’s symptoms through; educating one on skills to efficiently address one’s symptoms, assisting one to enable better think of the world, others as well as themselves, educating one on means of coping with possible symptoms which may emerge, and treatment of another issue which more often than not are associated with traumatic experiences, for example, anxiety, depression, or alcohol and drugs abuse.

PTSD with treatment

Once under PTSD treatment, a PTSD patient tends to seek out essential support from other individuals including family as well as friends (Harvey & Pauwels, 2013). An individual also finds an appropriate support group right after the traumatic event in question. Moreover, once one begins to undergo treatment a PTSD patient begins to eventually learn how to feel good in regards to their own actions when facing danger. Harvey and Pauwels (2013) point out that, in the long run, a PTSD patient begins establishing and implementing positive coping strategies to enable them to get over the traumatic event and even getting life lessons from the experience. Lastly, an individual gains the capacity and capability to effectively act as well as respond to situations despite having the feeling of fear.

PTSD without treatment

Harvey and Pauwels (2013) explain that when PSTD is prolonged without treatment it begins disrupting an individual’s entire life, beginning from their jobs, relationships, health, and even their enjoyment of day to day activities. Harvey and Pauwels (2013) further explain that PTSD may significantly increase an individual’s risks to exposure and development of other mental health-related problems, including anxiety, depression, drugs, and alcohol abuse, suicidal actions, and thoughts, as well as eating disorders.

Risk Factors of Post-Traumatic Stress Disorder

Scientists have discovered and defined several risk factors that may present a prediction of an individual’s likelihood of PTSD development (Galazyn, 2015). According to Galazyn (2015), an individual’s risk factors are classified into three distinguished categories; the pre, peri, as well as post-traumatic stages.

The pre-traumatic stage involves the history of an individual before undergoing trauma; these risk factors consist of genetics, age, sex where women face a higher risk than their men counterparts, mental health history, personality traits such as being an introvert, and prior trauma (Ford & Courtois, 2014). Ford & Courtois (2014) explain that the peri PTSD stages involves the time during the trauma it, therefore, includes the exposure level, the intensity of the trauma, and the perception of the traumatic event. Lastly, the post-traumatic stages involve the period after the traumatic event. Ford & Courtois (2014) expresses that these particular risk factors involve situations that are immediately available right after the traumatic experience.

Current Treatment Options

PTSD is a condition that could be treated, there are various PTSD proven treatments including;

Future Research Areas in Post-Traumatic Stress Disorder

PTSD to date has been treated through the utilization of mental health counseling as well as medication management, however, there are new treatments that are currently undergoing research today. Amongst the PTSD experimental treatments includes; MDMA with therapy, accelerated resolution therapy, virtual reality treatment, and even cannabis with therapy.

PTSD screening and diagnosis have exponentially improved in recent years. The current assessment methods are highly effective in the identification of PTSD severity in regards to PTSD symptoms as well as PTSD discrimination from the other psychiatric disorders. It is highly vital for PTSD treatment planning as well as monitoring of the outcomes. Increasing knowledge in regards to PTSD etiology as well as pathologic processes is appreciated through functional impairment which is carried out through the assessment of clinical interviews, performance-based measures as well as self-improved instruments.

Conclusion

All in all, quite a several PTSD screening tools that are well-validated together with diagnostic technologies are now in existence. Moreover, effective and highly efficient psychological as well as pharmacological PTSD treatments are substantially accessible and available. Unfortunately, even with these great advancements, quite a several PTSD patients including the veterans are unable to receive these treatments. Furthermore, future research should base significantly more focus on efforts to ensure these treatments are delivered to those in need.

PTSD is not a segregated issue that discriminates; rather it can hit any individual. PTSD does not choose a particular race, background, age, or even income level. Furthermore, PSTD is not secluded to soldiers only; it also falls on ordinary citizens. Not to mention that it may arise from a sudden trauma or a number subsequent series of traumatic events. Therefore, it is vital to creating awareness of the implications and importance of an in-depth understanding of PTSD to help anyone and everyone.

References

Adams, B. D., Davis, S. A., Brown, A. L., Filardo, E.-A., Thomson, M. H., Centre des sciences pour la sécurité (Canada),, & R et D pour la défense Canada,. (2013). Post traumatic stress disorder (PTSD) in emergency responders scoping study: Literture review.

Astorga, D. M. (2015). Educating veterans on Post Traumatic Stress Disorder.

Brewin, C. (2003). Posttraumatic stress disorder: Malady or myth?. New Haven: Yale University Press.

Courtois, C. A., & Ford, J. D. (2014). Treating complex traumatic stress disorders: Scientific foundations and therapeutic models.

Ford, J. D., & Courtois, C. A. (2016). Treating complex traumatic stress disorders in children and adolescents: Scientific foundations and therapeutic models.

Galazyn, D. F. (2015). A training workshop on veterans and complex trauma post-traumatic stress disorder: A grant proposal.

Harvey, J., & Pauwels, B. (2013). Post Traumatic Stress Theory: Research and Application. Hoboken: Taylor and Francis.

In Martin, C. R., In Preedy, V. R., & In Patel, V. B. (2016). A comprehensive guide to post-traumatic stress disorders.

Institute of Medicine (U.S.). (2008). Treatment of posttraumatic stress disorder: An assessment of the evidence. Washington, D.C: National Academies Press.

Poole, H. W. (2016). PTSD, post-traumatic stress disorder.

Poulson, Melodie. (2017). Become Educated on Ptsd: Post Traumatic Stress Syndrome. Xlibris Corp.

Regel, S., & Joseph, S. (2017). Post-traumatic stress. Oxford: Oxford University Press.

Soreq, H. (2010). Stress – from molecules to behavior: A comprehensive analysis of the neurobiology of stress responses. Weinheim: Wiley-VCH.