PTSD

Soldiers are especially susceptible to PTSD due to the incredibly high stress/violent environment which they operate in and bearing witness to traumatic experiences.

Post Traumatic Stress Disorder (PTSD) is a relatively new anxiety disorder that was added to the DSM in the 1970s as a result of the prevalence of the disorder among vietnam vets. This is not to say the disorder did not exist in prior generations, it simply went undiagnosed.

Copy of the DSM Section on PTSD including prevalence (8% adult lifetime) and diagnostic criteria: ptsd-definded-dsm-definition

Symptoms Include: 

  • Affective: anhedonia (inability to feel positive emotions), emotional numbing
  • Behavioral:  hypervigilance, passivity, nightmares, flashbacks, exaggerated startle response
  • Cognitive:  intrusive memories, inability to concentrate, hyper-arousal.
  • Somatic:  Lower back pain, headaches, stomach ache and digestion problems, insomnia, regression in some children, losing already acquired developmental skills (children).

PTSD does share some symptoms with the mood disorder depression however you’ll notice there are differences as well. The key is that PTSD’s etiology lies in an environmental trigger–some traumatic life event.

Etiology: 

Biological: Hauff and vaglum, 1994; Geracioti (2001); Bremner (1998).

Cognitive: Brewin et al. (1996); Sutker (1995); Sudfeld (2003).

Socio/Cultural:  Roysircar (2000); Dyregrov (1998); Silva (2000).

Treatment: 

Read the following excellent articles on PTSD in order to better understand both the disorder, and treatment approaches:

A revolutionary Approach to Treating PTSD

Discussion questions for Van Der Kolk PTSD article:

“Trauma has nothing whatsoever to do with cognition,” Van Der Kolk says. “It has to do with your body being reset to interpret the world as a dangerous place.”

**Before answering the questions below, consider the emphasis on the bi-directionality of the body and the mind put forth by Van Der Kolk and consider that in the context of learning outcomes such as, “discuss environmental effects on physiology” as well as “evaluate the extent to which cognitive and biological factors interact in emotion”

  1. How does psychomotor therapy leverage cognitive therapy? What are the similarities between psychomotor therapy and CT?
  1. What are Van Der Kolk’s critiques of CBT?
  1. What are Van der Kolk’s critiques of Exposure therapy?

Additional Alternative Treatments:

Alternative Medicine and PTSD

 Assignment Re: Etiology of PTSD designed to familiarize you with the studies involved (same as depression assignment, but just do part 1 !)

Understanding PTSD

From the Mayo Clinic Regarding PTSD Symptoms:

Post-traumatic stress disorder symptoms may start within three months of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions.

Intrusive memories

Symptoms of intrusive memories may include:

  • Recurrent, unwanted distressing memories of the traumatic event
  • Reliving the traumatic event as if it were happening again (flashbacks)
  • Upsetting dreams about the traumatic event
  • Severe emotional distress or physical reactions to something that reminds you of the event

Avoidance

Symptoms of avoidance may include:

  • Trying to avoid thinking or talking about the traumatic event
  • Avoiding places, activities or people that remind you of the traumatic event

Negative changes in thinking and mood

Symptoms of negative changes in thinking and mood may include:

  • Negative feelings about yourself or other people
  • Inability to experience positive emotions
  • Feeling emotionally numb
  • Lack of interest in activities you once enjoyed
  • Hopelessness about the future
  • Memory problems, including not remembering important aspects of the traumatic event
  • Difficulty maintaining close relationships

Changes in emotional reactions

Symptoms of changes in emotional reactions (also called arousal symptoms) may include:

  • Irritability, angry outbursts or aggressive behavior
  • Always being on guard for danger
  • Overwhelming guilt or shame
  • Self-destructive behavior, such as drinking too much or driving too fast
  • Trouble concentrating
  • Trouble sleeping
  • Being easily startled or frightened

Intensity of symptoms

PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you’re stressed in general, or when you run into reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.

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