Since the beginning of the twenty-first century, global human society has been critical to the achievement of sustainable development and quality healthcare. Only a few years ago, cultural wars, terrorism, pandemics, market crashes, drugs crimes among other social issues have threatened the peace of humanity from an individual to a society level. People are stressed or are afraid of self and neighbors since any instance is prone to result in trauma. Notably, reaction to traumatic events varies from one person to another. Some people are resilient, while others are very vulnerable. Traumatic events may lead to PSTD, which causes relieving of events, social avoidance, and hyperarousal. Symptoms and causative traumatic events help in the diagnosis and treatment approach through psychological and pharmacological approaches.
PSTD is a mental disorder, a consequence of exposure to traumatic (threatening or horrifying) situations. Such events include terrorist attacks, accidents, or life-threatening circumstances like violent crimes and assault. It can result from one traumatic event or exposure to horrific situations for an extended period. Such events are exceptionally stressful so that they precipitate a spectrum of psychological and physio-pathological issues (Iribarren et al. 504). Usually, people are resilient to stress, but resilience varies greatly from one person to another. One or multiple exposures to traumatic events reduces the immune capabilities against mental disorders, making victims more susceptible to PSTD (Iribarren et al. 504). Also, 3% of adults suffer PSTD at any given time, and the percentage tends to increase in areas prone to conflicts such as war zones (Bisson et al. h6162).
Patients suffering from PSTD reveal dissatisfaction in their health, social experiences, and professions. The dissatisfaction reveals through symptoms such as relive of events, avoidance, and increased arousal. Concerning heath, patients experience insomnia, and when they sleep, they experience the reliving of the thoughts and memories of the primary traumatic event(s) (Iribarren et al. 504). It also increases their psychiatric comorbidity. Most PSTD patients tend to have poor physical health, which aggravates their immunodeficiency, cardiorespiratory issues, and digestion problems (Bisson et al. h6162). Patients become socially detached with time, or become estranged. They avoid people, places, or things that remind them of the primary traumatic event. Iribarren et al. (504) report that PSTD symptoms are aggravated by events similar to the primary traumatic event, depression, substance abuse, and memory health issues. Eventually, patients deteriorate in their ability to handle social issues in families or in the community and end up losing occupations. They are excessively aroused emotionally, causing extreme irritation, outbursts, and inability to focus (Weston 2). In severe cases, the lives of PSTD patients are impaired and some experience suicidal thoughts or actions.
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According to the DSM-5, diagnosis of PSTD identifies symptoms and levels or trauma (Diagnostic and Statistical Manual of Mental Disorders n.p). Firstly, practitioners identify the cause of the trauma. The cause may be direct experience, witnessing a horrific event on another person, learning, or prolonged exposure to stress. Secondly, practitioners identify the recurrence of the event or relive the trauma. Patients may be asked about the nature and frequency of nightmares, thoughts that lead to the remembrance of the primary event(s), and their feelings towards various situations. Thirdly, practitioners identify the avoidance patterns of the patient. For instance, the type of thoughts, feelings, or conversations that patents are not willing to engage, and the people, places, or activities that arouse them. Fourthly, practitioners assess the cognition and mood of the patients by use of memory-test exercise, identification of exaggerations, or persistent negativity. Lastly, the diagnosis may identify the hyperarousal agents of the patients.
The clinical approach to PSTD recommends intervention in the therapeutic psychological approach. It may be individual trauma-focused or group trauma focus. In both approaches, psychologists use Trauma-Focused Therapy, Cognitive Behavior Therapy, and Eye Movement Desensitization and Reprocessing (Bisson et al. h6164). Therapists help patients to confront the trauma by recounting the primary event and re-occurrences in details. The recount is done through written, or verbal narration. Cognition Behavior Therapy seeks to identify the cognition anomalies that are likely to aggravate the impacts of the primary traumatic event (Bisson et al. h6164). In some cases, patients overestimate the impacts of events or exaggerate what happed to them. Weston (2) explains that the hyper-cognition is caused by the amygdala, which functions based on a set of ground cognition principles. Therefore, identifying the exaggerations and the possible reasons for exaggerations creates a basis for interning in the PSTD. EMDR involves bilateral physical stimulation. The procedure stimulates patients to remember and target the trauma causative event and use it in adaptive contextualized memory (Bisson et al. h6165). Other treatment methodologies include therapeutic experience in self-help groups and drug prescription in trauma-focused therapy.
Prevention and Management
Possible preventive interventions of PSTD concern psychology and pharmacology. Psychological prevention measures include debriefing, cognitive restructuring, coping skills therapy, normalization, psychological first aid (PFA) among others. Psychological debriefing is the education of patients about the common and normal reactions to trauma (Interventions for the Prevention of Post-traumatic Stress Disorder 3). Patients are given a chance to talk about their experiences and feeling concerning the traumatic event, and therapists point the normal reactions. Cognitive restructuring entails interpretation of the events that follow the primary traumatic events. That way, patients become more self-aware and work together with therapists to correct the negative thoughts concerning the events. Coping skills therapy includes techniques such as biofeedback or relaxation training. It enables patients to correct the grounded misconceptions in the amygdala, that may have developed due to the traumatic event. The PFA is a multiapproach preventive measure that reduces the distress on the primary event and supports patients in adapting to the implications of the event.
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One event or prolonged exposure to trauma may cause PSTD, which leads to relieving, avoiding, and increased arousal. Diagnosis of PSTD utilize symptoms and causative traumatic event, which are treated or prevented through psychological and pharmacological approaches. Patients suffering from PSTD reveal dissatisfaction in their health, social experiences, and professions. Practitioners use DSM5 to identify the prevalence of PSTD and recommend psychological and pharmacological treatment.
Bisson, Jonathan I et al. “Post-Traumatic Stress Disorder”. BMJ, 2015, p. h6161. BMJ, DOI:10.1136/bmj.h6161. Accessed 12 May 2020.
Diagnostic And Statistical Manual Of Mental Disorders. 5th ed., American Psychiatric Association, 2013.
Interventions for the Prevention of Post-traumatic Stress Disorder. “Interventions For The Prevention Of Post-Traumatic Stress Disorder In Adults After Exposure To Psychological Trauma | Effective Health Care Program”. Effectivehealthcare.Ahrq.Gov, 2012, https://effectivehealthcare.ahrq.gov/products/ptsd-adults-trauma-interventions/research-protocol.
Iribarren, Javier et al. “Post-Traumatic Stress Disorder: Evidence-Based Research For The Third Millennium”. Evidence-Based Complementary And Alternative Medicine, vol 2, no. 4, 2005, pp. 503-512. Hindawi Limited, DOI:10.1093/ecam/neh127. Accessed 12 May 2020. Weston, Charles Stewart E. “Posttraumatic Stress Disorder: A Theoretical Model Of The Hyperarousal Subtype”. Frontiers In Psychiatry, vol 5, 2014. Frontiers Media SA, DOI:10.3389/fpsyt.2014.00037. Accessed 12 May 2020