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Table of Contents
I. Introduction What is Post traumatic stress disorder? DSM-IV- TR Symptoms of post traumatic stress disorder II. A Growing Problem PTSD not only a Veterans Condition PTSD Statistics A community health problem Crime Victimization and PTSD Psychological consequences of crime Crisis reaction and equilibrium Trigger events for crime related PTSD Risk factors Recovery Process Treatment for PTSD Medications for PTSD patients III. Conclusion
after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat(NIMH, 2009).
Post traumatic stress disorder or PTSD, was once called shell shock, battle fatigue syndrome during WW II. PTSD got its name during the Vietnam war. PTSD is also known as battered womans syndrome. The name derived from battered women victimized by domestic violence.
PTSD Criterion- A.
DSMI-IV-TR
A. Exposure to a traumatic event The person experienced, witnessed, or was confronted with an event/s that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. Response involves intense fear, helplessness, or horror
PTSD Criterion- B.
DSMI-IV-TR
B. Traumatic event is persistently re-experienced in at least one of the following ways: Recurrent and intrusive thoughts or images Recurrent distressing dreams Acting or feeling as if the event were recurring Psychological distress upon exposure to reminders of event Physiological reactions upon exposure to reminders of event.
PTSD Criterion-C
DSMI-IV-TR
C. Avoidance of stimuli associated with the event and numbing of general response, occurring in at least three of the following ways: Efforts to avoid thoughts, feelings, or conversations about the event Efforts to avoid activities, places, or people that remind person of the event Inability to remember an important aspect of the event Significantly diminished interest or participation in activities Feeling of being detached or estranged from others Restricted range of affect Speaks or thinks of not having a future
PTSD Criterion-D
DSMI-IV-TR
D. Increased arousal not present before traumatic event, presenting in at least two of the following ways: Trouble falling or staying asleep Irritability or outbursts of anger Difficulty concentrating Hyper-vigilance Exaggerated startle response E. Symptoms last at least one month
Re-experiencing symptoms: Flashbacksreliving the trauma over and over, including physical symptoms like a racing heart or sweating Bad dreams Frightening thoughts. Re-experiencing symptoms may cause problems in a persons everyday routine. They can start from the persons own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing. Avoidance symptoms: Staying away from places, events, or objects that are reminders of the experience Feeling emotionally numb Feeling strong guilt, depression, or worry Losing interest in activities that were enjoyable in the past Having trouble remembering the dangerous event. Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car. Hyperarousal symptoms: Being easily startled Feeling tense or on edge Having difficulty sleeping, and/or having angry outbursts.
Symptoms
Depression Anxiety
Panic Attacks
Anger Outbursts Hyper-startle response Disturbed Sleep Pattern
Nightmares
Excessive sleep Insomnia
Self medication
Drugs
Alcohol
Symptoms
Hyper-vigilance
Constantly looking out for
danger Weight loss or weight gain Disturbed eating pattern Eating too much Not eating enough Trouble concentrating Agoraphobia Afraid to leave the house A result of feeling that the world is an unsafe place Problems with memory Short Term Memory loss Difficulty recalling details of the event.
addictions PTSD suffers have a high rate of absenteeism often times lose their jobs leading to economic deprivation Suffers may fail in their academic studies and goals. (Salvatore, R., 2009). High rate of suicide
Avoidance
A major symptom that is presented in PTSD is persistent avoidance of
virtually shuts down to protect the survivor's psyche from further trauma, allowing the victim to do what is necessary in order to function (NCVC 2009).
Avoidance
Examples of avoidance include:
Efforts to avoid thoughts, feelings or conversations associated with
the trauma Efforts to avoid activities, places or people that arouse recollections of the trauma; this is one reason why many victims will not leave their homes. Inability to recall an important aspect of the trauma Diminished response to the external world, or emotional amnesia. Markedly diminished interest or participation in significant activities; with children, they may regress developmentally and may begin bedwetting, or talking like a baby. Feelings of detachment or estrangement from others; Restricted range of affect or reduced ability to feel emotions such as feeling or giving love (NCPTSD 2009).
causes the survivor to relive the event. Triggers may be exhibited by : Hearing a firework go off- may trigger memories to a gunshot victim or war veteran; may think of memories of gunfire, or war; Seeing a car accident, may remind a crash survivor of their own accident Watching a rape survivor on the news may bring back memories of her/his assault A smell of cologne that was worn by the perpetrator during a sexual assault.
A Growing Epidemic
veterans condition. Secondary symptoms such as depression, and substance abuse are making this a National health problem.
Crisis Reaction
Victims will react differently to traumatic events Depending on the level of personal violation, their personality,
experiences, and support systems, their state of equilibrium at their victimization (NCVC 2009).
All people have a normal state of equilibrium called homeostasis.
It is influenced by everyday stressors such as:
illness, moving, changes in employment, and family issues. If a persons equilibrium is disrupted our bodies react, however they return to previous functioning levels. The combination of everyday stressors, in addition to being victimized, a persons equilibrium becomes overloaded making the person vulnerable to developing PTSD.
Victims of Crime
Victims of crime may self medication with drugs or alcohol.
In an attempt to psychologically numb Or block out the memories of the event.
Family and friends are often confused and do not understand the
condition. May feel helpless and frustrated Survivor may further deteriorate as a result. May become more depressed Isolated Suicidal Survivors often feel alone Afraid Feel shame May feel like its their fault.
proceedings Anniversaries of the event Holidays and other important family life events; such as birthdays.
event
External triggers may include seeing something on TV
trigger memories or flashbacks of the traumatic event. If the condition is left untreated, the victim's life may become dominated by attempts to avoid situations that remind him or her of the event (NCPTSD 2009).
chemistry.
critical, traumatic event will determine how each unique individual will respond, develop, or recover from PTSD.
Either by running away Fighting furiously. Or submit to the trauma In some individuals, once the brain goes through this chemical rewiring to survive the trauma, the wiring stays that way. (Briere, J., 2009).
or flight response.
produced when our bodies are feeling threatened, or in a high state of stress.
increased blood levels of the hormone, adrenaline (a.k.a. epinephrine). This chemical messenger produces several body changes including elevated blood pressure and increased pulse rate. These actions increase blood flow and, along with increased circulation to arms and legs, allow an animal to increase appropriate physical exertion capabilities (PBS 2009). This is what allows us to run quickly in order to escape an attack from the tiger.
will determine development, symptoms and behavioral signs. Two people can experience the same trauma, and one may come out with PTSD, and the other will not (Briere, 2009). Research has also suggested that the hippocampus may shrink and kill neurons.
This may slow down the growth of new neurons. This has lead to understanding why individuals with PTSD
sensitized. Resulting in the symptoms seen in PTSD. The complex chemical-neurological reactivity affects parts of the brain that are all about learning, memory, and fear conditioning (Briere, 2009). A neurochemical that plays a role in chronic stress is cortisol.
Cortisol is a hormone that is produced in the adrenal gland, producing
adrenaline. Also called the stress hormone because it tends to increase blood pressure, blood sugar levels, and has an immunosuppressive effect (Briere, 209).
in the average person. This helps explains the disturbed sleep and nightmares many PTSD suffers experience.
Since so many structures, hormones and neurotransmitters are involved in PTSD; the complex nature of PTSD has made it difficult in treating patients with one specific medication. Instead a combination of medications tends to work in concert with one another in order to relieve patient symptoms.
such as Noradrenalin Dopamine Serotonin the opiod systems, insulin, and cortisol all play complex roles in the PTSD symptom producing process (Briere, 2009).
Statistics
Families of homicide victimsthe impact of homicide on surviving family
members (Kilpatrick, Amick & Resnick, 1990) indicated that, almost 1 in 4 victims (23.4%) develop PTSD after the death of their loved one.
7.8%, with women (10.4%) twice as likely as men (5%) to have PTSD at some point in their lives.
Children who witness or are exposed to violence or abuse in the home are at high risk of developing PTSD.
Statistics
Rape victims
Are 13.4 times more likely to have two or more major alcohol problems. Are 26 times more likely to have two or more major serious drug abuse
problems.
The National Institute of Justice surveyed adolescents for victimization, mental health, and substance abuse issues.
A survey of 4,023 adolescents ages 12 to 17, 1.8 million adolescents have been
2.1 million have been subjected to physically abusive punishment 8.8 million have witnessed violence (National Institute of Justice, 1995).
Secondary symptoms and conditions may develop with PTSD. Co-occurring conditions may exist with PTSD, such as depression, anxiety disorders, and alcohol or other substance use disorders.
dates of the crime, or other potential triggers may trigger memories and cause them to re-experience the stress reactions in the future.
With effective treatment, survivors can learn to cope with symptoms and help to control symptoms of anxiety and depression.
Cognitive behavioral therapy and an integrated approach to therapy has proven effective
Medication may be needed for some survivors.
include:
experienced by sufferers
contact with the criminal justice system, should be screened for the presence of PTSD and provided with counseling referrals.
Due to the high risk for victims and survivors of
developing crime-related PTSD, mental health referrals and services for crime victims should be provided to all victims (NCPTSD 2009).
Conclusion
Crime does not discriminate and it can happen to anyone at anytime. The consequences of crime are devastating and can lead to post
Early intervention can help reduce the potential of developing PTSD, Early intervention is vital and has resulted in a better success rate than The connection:
PTSD , trauma, crime victimization, brain chemistry, the
those who do not seek treatment or seek treatment long after the event.
development of secondary symptoms such as: depression, anxiety, and substance abuse disorders are becoming more and more recognized as key components related to the condition making this a National Health Issue.
Conclusion
PTSD was first given its name during the Vietnam war. Society and the medical professions did not fully understand
Conclusion
With extensive research on PTSD, suffers can be treated and lead
desensitization reprocessing, and support systems are some interventions being used to help treat PTSD.
Research on PTSD and technology are advancing; there is hope that the
rewired bio-chemical system can be rewired one more time through therapy to help people regain the life they had before their traumatic event(Briere, 2009).
The statistics of crime victims with major crime-related mental health
problems make this a major health issue for communities and the nation (NCPTSD 2009).
References
National Center for Post-Traumatic Stress Disorder (2009) What is PTSD? www.ncptsd.org American Psychological Association. (2000) DSM-IV TR. Diagnostic Statistical Manual for Mental Disorders-IV Text revision. Washington DC. American Psychological Association Ackley & Ladwig. (2002). Nursing Diagnosis Handbook. A Guide to Planning Care (5thEd.) St. Louis. Mosby Salvatore, R., (2009). Posttraumatic Stress Disorder: A treatable Public Health Problem. National Association of Social Work, Volume 34, May 2009. Cougle, J.R., Resnick, H., Kilpatrick, D.G., ( 2009). A Prospective Examination of PTSD Symptoms as Risk Factors for Subsequent Exposure to Potentially Traumatic Events among Women. Journal of Abnormal Psychology, 2009. American Psychological Association 2009, Vol. 118, No. 2, 405411. Babcock,J.C., Roseman, A., Green, C. E., Ross, J.M., (2008). Intimate Partner Abuse and PTSD Symptomatology: Examining Mediators and Moderators of the AbuseTrauma Link Journal of Family Psychology 2008, Vol. 22, No. 6, 809818, American Psychological Association
References
Eadie, E., M., Runtz, M.,G., Spencer-Rogers, J., (2008). Posttraumatic Stress Symptoms as a Mediator Between Sexual Assault and Adverse Health Outcomes in Undergraduate Women. Journal of Traumatic Stress, Vol. 21, No. 6, December 2008, pp. 540547 (C _ 2008)
Neria, Y., Olfson, M., Gameroff, M.J., Wickramaratne, P., Gross, R., Pilowsky, D.J., Blanco, Cl, Manetti-Cusa, J., Lantigua, R., Shea,S., Weissman, M.M. (2008). The Mental Health Consequences of Disaster-Related Loss: Findings from Primary Care One Year After the 9/11 Terrorist Attacks. Psychiatry 71(4) Winter 2008 339
Schillaci, J., DeBakey, M.E., Yanasak, E., Harned- Adams, J, Dunn, N, Rehm, L.P., Hamilton, J.D. Guidelines for Differential Diagnoses in a Population With Posttraumatic Stress Disorder. Journal of Professional Psychology Research and Practice. Volume 40. No. 1. (pgs 39-45) National Center for Post Traumatic Stress Disorder http://ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_children.html EMDR-Therapy (2009). Eye Movement Desensitization Reprocessing http://www.emdr-therapy.com/ Briere, J.(2009). The Brain, Brain Chemistry, And PTS. National Child Traumatic Stress Network, SAMHSA. University of Southern California. http://hubpages.com/hub/The-Brain--Brain-Chemistry--And-PTSD