PTSD Expository Paper: Signs, Symptoms, and Treatments
Exposure to events involving death, significant injury, or sexual violence may cause post-traumatic stress disorder (PTSD). PTSD is prevalent in the aftermath of traumatic events and is one of the major health issues linked to higher mortality, comorbidity, and impaired functioning due to suicidal thoughts and acts. To account for the cognitive shift that characterizes PTSD, the DSM-5 now classifies the disorder under the heading Trauma and Stress Disorders (Mann and Marwaha). PTSD is characterized by negative modifications in cognition and arousal, and by symptoms of re-experience and aversion, and may have long-lasting detrimental effects on one’s quality of life. Many recent studies show advances in this sector since this condition initially gained public attention during and after U.S. military operations in Afghanistan and Iraq. However, the mechanism of the illness and its therapy are still poorly understood. All those caring for patients with this condition or under traumatic exposure should be aware of the dangers of developing PTSD due to the serious medical, social, and economical concerns PTSD entails for countries and people.
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A significant traumatic incident (interaction to imminent or threatened death, severe injury, or sexual assault) is required by the DSM5 (Bryant). Four clusters of symptoms should present themselves if one has encountered or seen such an incident. You must be undergoing some form of re-experiencing if you have overbearing unsettling memories, recurring distressing dreams, dissociative responses including flashbacks, severe or prolonged psychological distress when prompted by flashbacks of the traumatic event, or noticeable physiological responses to external or internal indicators signifying or befitting an aspect of the trauma. Second, one has to take steps to prevent themselves from being confronted with any trauma memories, whether internal (such as thoughts and recollections) or external (such as circumstances and discussions).
Subsequently, at least two symptoms falling under the category of “alterations in cognitions and mood” are required. These symptoms include things like: continual and inflated negative thinking about oneself or society; prolonged distorted cognitions about the catalyst or implications of the occurrence; inescapable negative emotions; significantly plummeted enthusiasm; feeling disengaged or alienated from others; and an incessant failure to experience positive feelings (Bryant). Last but not least, you need to exhibit at least two arousal symptoms, such as irritability and furious outbursts, risky or self-destructive conduct, heightened alertness, an increased startle reaction, difficulty focusing, or disturbed sleep. These symptoms need to persist for at least a month after trauma has been experienced to prevent the pathologization of healthy responses to stress (Bryant).
Assaults, both physical and sexual, and accidents and fires, are the most disclosed traumatic occurrences in the United States. Benjet et al. found that reports of accidents and injuries were the most common incident recorded around the globe. Military people, police officers, firefighters, and other first responders to catastrophes and mass trauma, as well as those from socially disadvantaged backgrounds and younger age groups, have all been shown to have higher incidences of PTSD. The conditional likelihood that post-traumatic stress disorder will emerge varies by sex and by the nature of the trauma experienced; for instance, the corresponding odds for men and women are 2% and 22% after a physical assault, 65% and 46% after rape, and 6% and 9% following an accident (Shalev et al.). There is a greater likelihood in nations with greater per capita income. These variations likely emulate the effects of sex and social and environmental circumstances on the onset, manifestation, and maintenance of PTSD symptoms. For instance, combatants trained to persist amid the action may not easily display dread, helplessness, or terror in the face of a physical attack. There may be gender differences in how such an assault is perceived.
Most research suggests that CBT, emphasizing trauma, is the most effective psychological treatment for PTSD. The current gold standard for preventative psychology is cognitive behavioral treatment delivered early on. Patients who fulfill the diagnostic criteria for PTSD benefit the most from it, and it works just as well whether given one month or six months after the traumatic incident, with benefits lasting for years. Recalling the traumatic experiences and the subsequent avoidance and cognitive distortions might be difficult, but this is what cognitive behavioral therapy is designed to do. Exposure treatments (such as extended exposure) and nonexposure therapies (such as cognitive restructuring) are two broad categories under which specific cognitive behavioral therapy protocols fall (e.g., cognitive processing). Traumatic memories that have been ignored out of anguish are confronted in exposure therapy. Disruptive thoughts and attitudes about trauma are investigated in cognitive processing therapy.
Drugs such as antidepressants, tranquilizers, hypnotics, and antipsychotics are often used to treat PTSD. According to Shalev et al., the FDA has authorized paroxetine and sertraline to treat post-traumatic stress disorder. Insomnia, nightmares, and sleeplessness have all been treated with mirtazapine, trazodone, and prazosin; topiramate has been utilized in individuals with PTSD and alcohol use disorder (Shalev et al.). Antidepressant medications have little effect on people with post-traumatic stress disorder. They reduce symptoms but seldom provide remission, and there is a high chance of return once treatment is stopped. Relapse may be prevented by maintaining a full therapeutic dosage for 6-12 months and then progressively decreasing it over many months. However, group-based estimations hide substantial response variability. Therefore clinicians are advised to assess the reactions of individual patients and adjust therapy appropriately.
Works Cited
Benjet, C., et al. “The Epidemiology of Traumatic Event Exposure Worldwide: Results from the World Mental Health Survey Consortium.” Psychological Medicine, vol. 46, no. 2, 2016, pp. 327–343., doi:10.1017/s0033291715001981.
Bryant, Richard A. “Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges.” World Psychiatry 18.3 (2019): 259-269.
Mann, Sukhmanjeet Kaur, and Raman Marwaha. “Post-traumatic Stress Disorder.” National Library of Medicine, National Center for Biotechnology Information, 7 Feb. 2022, www.ncbi.nlm.nih.gov/books/NBK559129/.
Shalev, Arieh, Israel Liberzon, and Charles Marmar. “Post-traumatic stress disorder.” New England journal of medicine 376.25 (2017): 2459-2469.