Post-traumatic Stress Disorder Research Paper

Post-traumatic Stress Disorder Research Paper

Posttraumatic stress is a set of psychological and physical symptoms that follow a traumatic experience. In some cases, these symptoms persist beyond the immediate aftermath of the trauma and develop into Posttraumatic Stress Disorder (PTSD), an anxiety disorder that includes symptoms of arousal, avoidance, and reexperiencing, lasts for more than 1 month, and causes significant impairment in social or occupational functioning. This research paper discusses the stress symptoms that commonly follow trauma and describes PTSD and its prevalence. The theories underlying the development and maintenance of symptoms are discussed along with the treatments used for PTSD and their efficacy.

PTSD Research Paper Outline

I. Reactions to Traumatic Events

A. Acute Reactions

B. Posttraumatic Stress Disorder

C. Course of PTSD

II. Measures of PTSD

A. Interviews

B. Self-Report Measures

III. Prevalence of PTSD

IV. Vulnerability and Resiliency Factors

V. Concomitant Problems Following Trauma

VI. Theories on the Development and Maintenance of PTSD

A. Psychoanalytic Theories

B. Cognitive and Behavioral Theories

C. Psychobiological Approaches

VII. Psychological and Pharmacological Interventions

A. Early Interventions

B. Cognitive-Behavioral Therapies

1. Prolonged Exposure (PE)

2. Stress Inoculation Training (SIT)

3. Cognitive Therapy

4. Cognitive Processing Therapy (CPT)

5. Eye Movement Desensitization and Reprocessing (EMDR)

C. Pharmacotherapy

D. Hypnotherapy and Psychodynamic Psychotherapy

VIII. Bibliography

I. Reactions to Traumatic Events

Psychologists and physicians have long been interested in vulnerability and resilience factors in reaction to extreme stress. Earlier accounts of posttrauma reactions focused on descriptions of cases. Spurred by inclusion of Post-traumatic Stress Disorder (PTSD) in the psychiatric diagnosis nomenclature in 1980, experimental research has examined many facets of the phenomenon.

In the Diagnostic and Statistical Manual (DSM-IV) published by the American Psychiatric Association in 1994, a trauma is defined as an experienced or witnessed event that involves threat of death or serious injury, and which evokes feelings of terror, horror, or helplessness. Thus, events such as anticipated death of a loved one, job loss, or divorce would not qualify as a trauma in this formulation. The International Classification of Diseases (ICD-10), published by the World Health Organization in 1992, describes a traumatic event as having an exceptionally threatening or catastrophic nature, which would be likely to cause pervasive distress in almost anyone.

The most common traumas studied are combat, sexual assault, sexual abuse in childhood, criminal victimization, torture, accidents, and natural disasters. Larger-scale traumas, such as mass migration, refugee camp experiences, and holocausts, have not yet been thoroughly researched. Clearly, such mass traumas would be expected to have considerable impact on those individuals directly affected as well as on their children, communities, and cultures.

A. Acute Reactions Post-traumatic Stress Disorder Research Paper

A number of physical and psychological symptoms are considered common reactions immediately after a traumatic experience. Many trauma victims report being disoriented and anxious after a trauma and have difficulty sleeping and concentrating. Victims are often reluctant to talk about the trauma or deliberately contemplate it; nevertheless the traumatic memory intrudes on their thoughts quite frequently. In recognition of the severe distress and psychological dysfunction that often occur immediately after a trauma, a new diagnostic classification called Acute Stress Disorder (ASD) was adopted in the DSM-IV in 1994. The focus of this disorder is on dissociative features, and, consequently, the symptom criteria include at least three of the following: a sense of numbing, detachment, or lack of emotional responsiveness, a reduction in awareness of surroundings (e.g., being in a daze), derealization, depersonalization, and dissociative amnesia. Reexperiencing of the trauma, avoidance, and arousal, as defined in the criteria for PTSD, must also exist. A diagnosis of Acute Stress Disorder is warranted when such symptoms last between 2 days and 1 month, occur within 1 month of the trauma, and interfere significantly with daily functioning.

B. Posttraumatic Stress Disorder

Posttraumatic Stress Disorder, as described in DSM-IV, is a set of symptoms that begins after a trauma and persists for at least 1 month. The symptoms fall into three clusters. First, the individual must reexperience the trauma in one of the following ways: nightmares, flashbacks, or intrusive and distressing thoughts about the event; or intense emotional distress or physiological reactivity when reminded of the event. Post-traumatic Stress Disorder Research Paper

Second, the individual must have three of the following avoidance symptoms: avoidance of thoughts or feelings related to the trauma, avoidance of trauma reminders, psychogenic amnesia, emotional numbing, detachment or estrangement from others, decreased interest in leisure activities, or a sense of foreshortened future.

Post-traumatic Stress Disorder Research Paper

Third, the individual must experience two of the following arousal symptoms: difficulty falling or staying asleep, difficulty concentrating, irritability or outbursts of anger, hypervigilance, or an exaggerated startle response. To meet diagnostic criteria for PTSD, the symptoms must cause significant impairment in daily functioning. These criteria provide a good operational definition of PTSD, as they describe the symptoms seen in most cases.

However, the three categories of symptoms are not empirically validated as distinct symptom clusters. For instance, it is not clear that the symptoms of behavioral avoidance and emotional numbing are similar and belong in the same category. Post-traumatic Stress Disorder Research Paper

The ICD-IO criteria for PTSD also include some reexperiencing symptoms (nightmares, flashbacks, distress on exposure to reminders), actual or preferred avoidance of trauma reminders, and either an inability to recall important aspects of the trauma or sustained psychological sensitivity and arousal (sleep disturbance, hypervigilance, difficulty concentrating). These three criteria must all be met within 6 months of the traumatic event for a diagnosis to be given. Post-traumatic Stress Disorder Research Paper

Several differences between the two definitions can be identified. First, the DSM-IV specifies a minimal number of symptoms that need to be observed to receive the diagnosis, whereas the ICD-IO leaves more freedom for clinical judgment. The advantage of the former approach is its utility in clearly operationalizing the concept of PTSD. The disadvantage is its rigidity and the possibility that one symptom can determine diagnostic membership. Second, the ICD-IO does not recognize the numbing symptoms, which together with flashbacks and nightmares are thought to be cardinal features of PTSD. Third, arousal symptoms are optional in the ICD-IO but are required in the DSM-IE Clinical observation and theoretical accounts of PTSD support the importance of these symptoms and render the ICD-IO diagnostic criteria less satisfactory. Post-traumatic Stress Disorder Research Paper

C. Course of PTSD

The course of PTSD is variable. For the majority of individuals, symptoms begin immediately after the trauma, although some appear to have a delayed reaction. During the first 3 months after the trauma, the individual is said to have acute PTS………………………………

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Post-traumatic Stress Disorder Research Paper