Posttraumatic Stress Disorder ( PTSD)
Unlike the anxiety disorders, like phobia and OCD , which typically are triggered by objects or situations that most people would not find threatening, the situations that cause posttraumatic stress disorder like combat, rape, earthquake, airplane crash, would be traumatic for anyone. An example would be the attacks of September 11 which resulted in mass casualties and injuries, affecting not only the immidiate victims and survivors but the entire nation, as millions witnessed the resulting death and destruction on televisions. At this time people became prone to PTSD. More common examples may include, motor vehicle accidents and war veterans and rape victims.
If the symptoms begin within four weeks of the traumatic event and last for less than a month, DSM-IV assigns a diagnosis of acute stress disorder. If the symptoms continue longer than a month, a diagnosis of posttraumatic stress disorder is assigned. The symptoms of PTSD may begin either shortly after the traumatic event or months or years afterward. Many cases of acture stress disorder develop into PTSD. Some common symptoms are listed below:
- Reexperiencing the traumatic event: People may be battered by recurring memories, dreams, or nightmares connected to the event. A few relive the event so vividly in their minds that they think it is actually happening again ( flashback).
- Avoidance: People will usually avoid activities that remind them of the traumatic event and will try to avoid related thoughts, feelings, or conversations.
- Reduced responsiveness: People feel detached or estranged from other people or lose interest in activities that once brought enjoyment. They may lose their ability to experience such intimate emotions as tenderness and sexuality.
- Increased arousal, anxiety, and guilt: People with these disorders may feel overly alert ( hyperalertness), be easily startled, develop sleep problems, and have trouble concentrating. They may feel extreme guilt because they survived the traumatic event while others did not.
In attempting to explain why some people develop PTSD and others do not, researchers have focused on biological factors, personality factors, childhood experiences, social support, and the severity of the traumatic event.
- Biological factors: Invesgators have gathered evidence that traumatic events trigger physical chances in the brain and body that may lead to severe stress reactions and, in some cases, to stress disorders. They have, for example, found abnormal activity of the hormone cortisol and the neurotransmitter/hormone norepinephrine in the urine and blood of combat soldiers, rape victims, and survivors of other severe stresses.
- Personality factors: Some studies suggest that people with certain personality profiles, attitudes, and coping styles are more likely to develop stress disorders. For example, people who are anxious and have some psychological problems before the stressful event are more likley to develop PTSD. Also, people who generally view life's negative events as beyond their control tend to develop more severe stress symptoms after stressful events.
- Childhood Experience: Some studies have found that certain childhood experiences seem to leave some people at risk for later acute and posttraumatic disorders. People whose childhood have been marked by poverty, psychological disorders of family members, assault, abuse or catastrophe at an early age appear more likely to develop these disorders in the face of later trauma.
- Social support: It has been found that people whose social support systems are weak are more likely to develop a stress disorder after a traumatic event.
- Severity of trauma: The severity and nature of traumatic events help determine whether an individual will develop a stress disorder. Some events can override even a nurturing childhood, positive attitude, and social support. Generally, the more severe the trauma and the more direct one's exposure to it, the greater the likelihood of developing a stress disorder.
Techniques used to treat the stress disorders include:
Drug Therapy: Antianxiety drugs help control the tension and exaggerated startle responses that many clients experience. In addition, antidepressants may reduce occurance of nightmares, panic attacks, flashbacks, and feelings of depression.
Behavioral Therapy: Behavioral exposure techniques have helped reduce specific symptoms and they have often led to improvements in overall adjustment.
Eye Movement Desensitization and Reprocessing ( EMDR): in which clients move their eyes in a saccadic, or rhytmic, manner from side to side while flooding their mind with images of the objects and situations they ordinarily try to avoid.