Posttraumatic stress disorder

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Posttraumatic stress disorder is one of the few mental disorders that are triggered by disturbing outside events either through witnessing it or experiencing it. Many people who undergo traumatic situations have a difficulty in coping and adjusting for a while but do not have PTSD.With good self-care, they usually improve and get better than before. However, if the symptoms persist for months or years and interferes with one’s’ functioning one may end up with posttraumatic stress disorder.

According to American Psychiatric association journal (2012) Physical and emotional symptoms of PTSD occurs in three clusters such as avoidance of usual activities, re experiencing the trauma and increased arousal of symptoms. Most of the patients with PTSD have at least one psychiatric disorder that is morbid.Most of the morbid disorders include depression, drug and alcohol abuse and another anxiety disorders.

According to Breslau et al., (2011) criteria of diagnosing PTSD specifies factors concerning victim’s perception of trauma as well as the time and impact of associated symptoms. It includes the avoidance of usual activities, persistent re experiencing the traumatic event, increased arousal of symptoms.Before diagnosing PTSD, symptoms must last for at least some few months, and it must affect the normal activities. For a person who has survived a traumatic event anxiety syndrome that lasts less than two months is termed acute stress disorder, these condition needs three or more dissociative symptoms in addition to persistent symptoms associated with PTSD.Symptoms that last less than three months indicates an acute post traumatic stress disorder. Delayed picture may occur in patients who begin experiencing symptoms more than six months after a traumatic event occurs

Diagnosing PTSD may be difficult to make because patient may not be a position to recognize the link between experienced traumatic event and symptoms. Some patients may not be willing to disclose the situation they underwent or presentation is obscured by substance abuse or depression (Breslau et al., 2013).

According to Monicah et al., (2013) one of the predictors of onset of PTSD and depression is gender, females are more prone to depression. Data from a nationally representative national comorbidity survey indicated that the prevalence of depression in USA was twice higher in females compared to males. In addition, the PTSD was twice higher as that of males.

Exposure to interpersonal violence such as sexual assault is another risk factor of developing depression and PTSD.A Meta analysis done indicates that men and women are equally at risk of developing depression and PTSD following an assault. Though women are at a greater risk of assault it plausible that greater exposure accounts for the higher risk of PTSD onset among women.Moreover, women in the US shows a twofold rise in the risk of PTSD among women following an assault. The twofold increase risk of PTSD persists over a wide range of traumatic events including non-sexual assaults, traffic accidents, and even serious illnesses among others. The results suggest that women show differential susceptibility to risks (Monicah et al., 2013).

According to Uddin et al., (2011) approximately 25 to 30 percent of victims of traumatic situations develop symptoms of PTSD.However, the response varies with the severity of trauma. For example, men exposed to military combat and those that witness people’s killings are diagnosed with PTSD but in women, it is mostly rape cases.

According to Angel et al., (2012) persons who have once been victimized are at a higher risk of being victimized again.History of childhood abuse increases rise of victimization and PTSD in adults. This is because there is a strong relationship between victimization by assault and mental disorders. Hence, presence of mental health issues increases chances of one being a victim of PTSD.

Epigenetic factors are the possible factors that increase the risk of PTSD, depression among sex differences.Sex differences in epigenetic factors influence brain development, and it is a potential source of dimorphic sexual risk for development of neurological and mental health disorders later in life that includes autism spectrum disorder. Although data from few researches about PSTD shows that genetic factors increase vulnerability to PTSD if inadequate threat is exposed. However, age and ethnicity seems to have no effect on morbidity (Angel et al., 2012).

According to Dean et al. (2011), etiology of PTSD is unknown but most investigations believe that a personal predisposition is one of the triggering factors for the development of symptoms after a traumatic event. Clinical minority of people develops symptoms after a traumatic event. Those who are likely to develop PTSD tend to have a pre-existing anxiety disorder or family history of anxiety

From a biological perspective view body’s failure to return to its normal state before, trauma differentiate PTSD from simple fear. In that normal fear activates sympathetic discharge that later on activates the flight or fight response. Increase in both cortisol and catecholamine’s occurs relatively to severity of the stressor.Cortisol release stimulated by corticotrophin releasing factor via hypothalamic pituitary adrenal axis acts in a negative feedback loop to suppress sympathetic activation and cause a further release of cortisol.Hence increased levels of cortisol in a person under traumatic situation such as vehicle wreck stands a higher chances of getting PTSD (Dean et al., 2011).

An individual exposed to traumatic stress develops chronic PTSD.Therefore, there is variability in stimuli and perception as well as individual vulnerability to trauma. This makes treatment interventions to be limited because pathways’ leading to vulnerability of trauma is limited. Hence, this contributes to etiology of PTSD this is according to Dean et al., (2011).

Most of the factors contributing to post traumatic stress disorder includes genetic and epigenetic factors, psychosocial factors, and past trauma exposure. Epigenetic factors are the ones contributing to increased stress in adulthood that risks one to develop posttraumatic stress disorder.

Hippo camp dysfunction interacting with one traumatic situation influences the maintenance and etiology of PTSD.Such as inability to form conjunctive context may leave one dependent upon elemental context representation history; thus one is prone to respond with fear in the future in the presence of single elements that were encoded during trauma (Dean et al., 2011).

Treatment of PTSD patients relies mostly on a multidimensional approach. Treatment options may include anxiety management, pharmacological support, and social support of the patient. Patient education and social support should be the first interventions to mitigate the impact of trauma. Support groups can also help in destigmatization of the mental health diagnosis and reaffirming that PTSD symptom requires treatment. Family support is also important because it encourages acceptance and understanding that alleviates survivor’s guilt (Cohen, 2011).

According to Davis et al. (2010), cognitive behavioral therapy is effective in eliminating PTSD symptoms. Studies done on patients who were under cognitive behavioral therapy over a period showed positive end state function. Other types of cognitive behavioral therapy include stress variolation training. This focuses on ways patient will overcome fear and develop anxiety management methods.

In conclusion, PSTD is a mental condition caused by external factors that one predisposes to oneself. Condition is hard to diagnose since most people fears stigmatization in the society, for example, one who has undergone rape may not reveal the case but remains in denial with depression and anxiety and end up having PTSD. In terms of treatment, cognitive behavioral therapy is the best therapy because it emphasizes mostly on the real situation and ways of coping with the situation.

References

American Psychiatric Association. (2012). Diagnostic and Statistical Manual of Mental

Disorders 3 ed.Washington: American Psychiatric Association, 3-232.

Breslau N., Peterson E., & Kessler R. (2011).Short Screening Scale for DSM-IV Posttraumatic

Stress Disorder. Am psychiatry, 156:11-908

Yehuda, R. (2011).Biology of Posttraumatic Stress Disorder.Jclin Psychiatry, 61 (7)14-21

Monicah, U., Levent, S. & Karestan, S. (2013). Sex Differences in DNA Methylation may to Risk

Of PTSD and Depression.Depression and Anxiety Journal, 30: 1151 -1160

Uddin, M., Koenen, E. (2011). Epigenetic, and Inflammator Marker Profiles Associated with

Depression in a Community Based Sample. PsycholMed, 41:997-1007.

Angel, L., Mary, A. & Beth, E. (2012).Post Traumatic Stress Disorder is Associated with Poor

Health Behaviours.Health Psychology, 31(2) 194-201.

Dean, T., Jodi, E. & Victoria, B. (2012).Hippocampal Dysfunction Effects on Context Memory

Possible Etiology for Post Traumatic Stress Disorder.Neuropharmacology, 62: 674-685.

Cohen, H. (2011). Treatment of PTSD.Psych central. Retrieved on June 6 2014, from

HYPERLINK “http://psychcentral.com/lib/an-overview-of%20treatment%20-of-ptsd/00161” http://psychcentral.com/lib/an-overview-of treatment -of-ptsd/00161

Davis, L. Ambrose, M. & Petty, F. (2010). Pharmacotherapy for Posttraumatic Stress Disorder; a

Comprehensive Review. ExpertOPinPharmcother, 2:95-1583