Post-traumatic stress disorder.

Post-traumatic stress disorder is a crippling mental ailment that arises when a person encounters or observes an extremely terrible, traumatic, or horrific incident. The American Psychiatric Association changed the diagnostic criteria for this condition in the fifth version of the DSM, and the disorder was classified as Trauma and Stressor-Related Disorders. The distinction of PTSD is that it is the only psychiatric diagnosis that is based on a traumatic stressor. This indicates that unless the affected person is exposed to a traumatic experience, he or she cannot be diagnosed with PTSD. Domestic violence, child abuse, devotion membership, and stalking are examples of traumatic situations. A person affected by PTSD can be healed after many years or even remain impaired for the rest of their life. The survivors of traumatic events with PTSD have been successfully treated with therapies. Peer counseling groups have also supported some people (Javidi & Yadollahie, 2011). The collective experiences of people who have PTSD are nightmares, flashbacks of events, a recurring experience of traumatic events in a day stream, concentrating difficulties and insomnia. PTSD is caused by a variety of factors which may be physiological, socio-cultural, or personal variables.

Physiological Causes

From current research of the neurobiology, lasting changes which encompass abnormal secretion of stress hormones cause traumatic events in most individuals. Furthermore, examination of the patients with PTSD has shown changes in the parts of the brain that connects fear and distress (Roberts et al., 2011). Ketamine experiments have also demonstrated that trauma works in a way - which destroys the pathways associated with the mind - that alters brain parts which control language and speech.

Socio-Cultural Causes

A research of a particular population of patients who have post-traumatic stress disorder and the survivors of trauma might develop a compassion fatigue which is a secondary PTSD. People who are probably exposed to trauma include the disaster investigators, firefighters, police officers, and emergency medicine specialists (Javidi & Yadollahie, 2011). However, failure to resolve issues from the personal history of the workers, the quantity and intensity at which a person is exposed to the victims suffering from trauma, the level of sympathy and sensitivity of the workers are the factors related to the possibility of escalating the level of PTSD.
Personal variables

People are different in their cognitive and emotional response towards a traumatic event. Even though the primary cause of PTSD is the event, those people who are more vulnerable are associated with the disposition of nature with interested individuals remaining a higher risk prior traumatization. Conversely, a physical disability or illness that is chronic leads to an individual vulnerability.

The symptoms of PTSD

A traumatic stressor is the exposure of a patient to an event that is disastrous which involves actual or a threat to the self or others. At the time of the traumatic event, the emotional response of an individual is characterized by a feeling of helplessness, nightmares, and intense fear. General intentional causes of stress by human beings, such as rape, are considered to be highly traumatic compared to natural, disasters or even accidents. Intrusive symptoms arise from a process of memory formation that is abnormal. As the patient relieves the traumas she experiences traumatic daydreams and nightmares, flashbacks just like the events were repeating currently. The characteristics of a traumatic memory are that they can be initiated by a response that makes a patient remember that traumatic experience, they also have a wordless feature which consists of pictures and senses instead of being described verbally.

Avoidant symptoms include a feeling of disconnected from others, withdrawal from some place or people connected to trauma and mental sensation. An individual tries to lower the possibility of being expressed to things that activate the trauma memories. The patients also reduce their responses to the traumatic memories. Hyper-arousal refers to a condition in which the nervous system of a patient is ever on the alert for the recurring of the event. It includes insomnia, concentrating on difficulty, general irritability, and extreme frighten response and hype vigilance (Lyons, Zink & Koenen, 2012). The symptom must occur persistently for at least one month. Significance involves the usual social symptom of PTSD which makes a patient feel disconnected from others. As a result, the victim undergoes significant social problems associated with his or her job.

Diagnosis of PTSD

Diagnosis is quite an issue because of a range of reasons; symptoms may reduce depending on the time of onset of the trauma. A delayed response makes the diagnosis of PTSD to be more difficult as some people develop symptoms after several months or even years from the time an event occurred. DSM-IV-TR shows a specification on the distance of six months from the time an incident occurred and the time of symptoms developed from PTSD (Roberts et al., 2011). Also, individuals exhibit variations in response to stressors. DSM-III include a group of adjustment disorder to give the difference of the reaction that is abnormal to painful events that are common like loss of job, bereavement or divorce from the symptoms that result from trauma are overwhelming.

Besides, most of the PTSD patients have also been diagnosed with anxiety somatoform disorder, dissociate or mood, through dual diagnosis. About a half of the people with delayed response to PTSD symptoms are diagnosed with a disease that is personal, often borderline personality disorder and substance abuse disorder (Surgeon, 2015). More than a half of PTSD patients get to alcohol so that they can numb the memories that are painful. Furthermore, the diagnosis of PSTD is more often made from the history of the patients and lead to interviews with short answers. Instruments used in the evaluation of PTSD include the dissociative experiences scale (DES), clinical administered PTSD scale (APS), the disorder of extreme stress inventory (DESI), the impact of event scale (IES), the Hamilton anxiety scale, the anxiety disorder interviews (ADIS) and the beck depression inventory.

Treatment of PTSD

Psychological and social intervention - treatment involves clinical treatment trial of PTSD for the patients who are severely affected. Patients who are affected within 48 hours from a civilian disaster can be treated by critical incident stress briefing (CISD) which weakens the oppressing symptoms of the trauma (Lyons, Zink & Koenen, 2012). The emergency response workers, stress reaction therapists, and public safety personnel are intervened by critical incidents stress management before they progress to secondary PTSD. Patients who have already developed PTSD can also be treated by cognitive behavior therapy, psychodynamic, psychotherapy, discussion or peer counseling groups and family therapy.
Medications are used on those patients who have developed harsh PTSD to treat the symptoms that are intrusive to the disorder and the anxiety feeling and depression. Selective serotonin reuptake inhibitors assist in suppressing symptoms in five to eight weeks while anxiety and depression are treated with tricyclic antidepressants or the monoamine oxidase inhibitors.

Alternative therapies such as spiritual or religious counseling, yoga and other forms of bodywork - martial arts training like model mugging - helps to release physical tension. Also, the post-traumatic disorder is treated using art therapy, journaling dance therapy, and creative writing groups which give passages for the emotions that are strong due to the traumatic events. Recent controversial treatments include reducing the sensation of eye movement, Tapas Acupressure Technique which was obtained from the traditional Chinese medicine (TCM), thought field therapy, traumatic incidents, reduction emotional freedom techniques and the counting technique.

Summing up, post-traumatic stress disorder is a mental illness which results from a person's experience of traumatic events such as devotion membership, domestic violence, and natural disasters. The condition is caused by a variety of factors which encompass physiological and socio-cultural influences, and personal variables. The symptoms of PTSD can be categorized into intrusive, avoidant, and hyperarousal. However, these indications must occur persistently for at least one month. Diagnosis of a post-traumatic disorder is quite challenging because of reduced symptoms as a result of delayed response, dual diagnosis, psychological measures, and individual variation in response to the stressors. The treatment involves psychological and social interventions, medications, and alternative therapies.

The accuracy of the fifth edition of the DSM diagnostic criteria for PTSD is questionable as it is not clear how the changes affect the clinical utility and prevalence of the disorder. Events that do not qualify as stressors under DSM-5 cause the disorder suggesting that PTSD may be a stress response syndrome that is aberrantly severe but non-specific. It is crucial for the clinical officers to contemplate the way discordant outcomes can be managed, especially for veterans with PTSD and the service members who do not meet standards under DSM-IV. However, this diagnostic criterion is critical because it is used in legal jurisdictions. The stressor criterion is not informative in characterizing the symptoms of PTSD.

References

Javidi, H., & Yadollahie, M. (2011). Post-traumatic stress disorder. The international journal of occupational and environmental medicine, 3(1), 8-12.

Lyons, M. I., Zink, T., & Koenen, K. C. (2012). Post-traumatic stress disorder. Principles of Psychiatric Genetics, 134.

Roberts, A. L., Gilman, S. E., Breslau, J., Breslau, N., & Koenen, K. C. (2011). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological Medicine, 41(1), 71-83.

Surgeon, P. (2015). Post-traumatic stress disorder. The Encyclopedia of Civil War Medicine, 250.