Post Traumatic Stress Disorder Post traumatic stress disorder, also known as PTSD, is a mental illness that affects people (of no particular demographic) who have been subjected to one or several psychological and/or physical traumas in the past. It is classified as an anxiety disorder and can affect any people who have experienced a traumatic event in their life, like war, rape/sexual abuse, child abuse, torture, being informed of a fatal disease, discovering a dead body, experiencing a natural disaster/accident or being kidnapped. It does not only affect adults, children can develop PTSD – child abuse (physical or sexual) is a major contributor of PTSD developing in children. The symptoms of post traumatic stress disorder affect the sufferer in different ways. Several symptoms will intrude on the sufferer leading a stress-free life, with disturbing and distressing thoughts/images, distress when they are reminded of the traumatic incident, physical signs of anxiety and distress when confronted with a trigger of the traumatic event, nightmares & feeling of reoccurrence of the incident. The sufferer will display some physically disturbing symptoms, like over-awareness of possible dangers, being easily startled, disturbance of sleep, difficulty concentrating, easily losing their temper and irritability. The symptoms that are the most noticeable of PTSD sufferers are those that visibly cause disinterest or signs of avoidance of dayto-day activity. These include a feeling of disconnection from others, being in a depressed state & being unable to feel any kind of affectionate emotion, avoiding any kind of trigger of the traumatic event, withdrawal of social life, loss of optimism & positive foresight, forgetting a pivotal part of the traumatic incident and the avoidance of thinking about the incident. Due to the symptoms attached from post traumatic stress disorder, several social, physical and mental impairments and dysfunctions are endured by sufferers. Many victims of the disorder have a strained social life, as they are often unable to easily make new friends and continue relationships with current friends. Their disinterest with some activities could lead to sexual dysfunction. People with PTSD can also suffer from a sleep dysfunction, due to nightmares and thoughts (and, to some sufferers, attempting to avoid the thoughts) about the traumatic event. The DSM-IV-TR is the current version of the Diagnostic and Statistic Manual of Mental Disorders. It assists mental health professionals in diagnosing a patient, and provides diagnostic criteria to try and specifically analyze if a patient is suffering from a mental illness, and if so, what it is. The latest edition is organized in five axis. These levels separate different disorders/disabilities in relation to different factors which cause/affect them. These are: Axis 1Clinical disorders Axis 2Personality disorders & mental retardation Axis 3General medical conditions Axis 4Psychosocial and environmental problems Axis 5Global assessment of functioning
The impairments caused by PTSD could be considered as abnormal. Normality is the state of behaving in a way that is accepted as being typical and ordinary by modern society. Abnormality is the opposite of this, to act in a way that the modern society would deem inappropriate and would normally draw to others attention. Psychologists have identified six main ways to classify and interpret the way a person reacts is normal or abnormal. These six approaches are: •
Sociocultural – behaviour accepted in specific cultures and societies, whereas it isn’t accepted in others.
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Functional – behaviour accepted as normal because the individual are able to function properly.
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Historical – behaviour accepted normal in one era, but not in modern times.
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Situational – behaviour that is acceptable in one situation, but not others.
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Medical – behaviour that isn’t acceptable only because of a medical affliction that cause such actions.
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Statistical – behaviour accepted due to statistical evidence suggesting the majority of people behave like this
Functional is the approach used to describe how PTSD is considered abnormal. Sufferers will often be unable to participate in any kind of social life. Sufferers are often withdrawn and cannot begin relationships with other and aren’t able to function well with other people. The problems that they can have with their sleeping patterns (nightmares relating to traumatic event etc.) can also cause difficulties with their ability to do basic daily activities (e.g. get out of bed in the morning or eat nutritiously). Also, the way a PTSD sufferer will respond to distress could be considered as abnormal, in the situational sense. This is because, sufferers will often respond in the ‘flight or fight’ response – regardless of whether they are in actual danger or not. Those affected with the disorder could also be interpreted as being abnormal in the situational approach due to their reactions to certain triggers. A public response to a trigger (a war veteran hearing a car backfire in the street, reminding him of gunfire from the war) will most likely cause the individual to be distressed physically (sweating, breathing difficulties) and psychologically (hysteria, tension). This, of course, is normal for PTSD sufferers but it isn’t an acceptable form of behaviour in most situations. When diagnosing this disorder, the traumatic event(s) that caused the person to possibly be suffering from this disorder. This needs to be accounted for because it can determine the severity of the condition and can review what treatment is required and how long the patient has been living with the disorder. After the diagnosis, recognition of certain triggers will need to be identified to understand what makes the individual react to thoughts of the traumatic incident. According to the DSM-IV-TR, the criterion for accurately diagnosing PTSD is six-fold: a. The exposure to a traumatizing event
b. Persistent reoccurrence to the event (e.g. flashbacks, dreams) c. Avoiding anything that triggers or reacts to the thought of the event d. Persistent symptoms of hyper arousal e. Having the symptoms for more than one month f.
Significant social, occupational and/or physical impairment.
This criterion may be too broad as it has been revealed since the introduction of this, there has been a distinct number of possible PTSD cases. However, extraneous variables (for example, the Iraqi war) may explain this. The most effective course of treatment, proven to help PTSD, is cognitive behavioural therapy. Cognitive behavioural therapy attempts to change how one thinks and aims to change the thought processes that cause distress to their body and, when trying to treat PTSD, identify why & how the trauma distresses them and aggravates the symptoms. The DSM-IV-TR is the current version of the Diagnostic and Statistic Manual of Mental Disorders. It assists mental health professionals in diagnosing a patient, and provides diagnostic criteria to try and specifically analyze if a patient is suffering from a mental illness, and if so, what it is. The latest edition is organized in five axis. These levels separate different disorders/disabilities in relation to different factors which cause/affect them. These are: Axis 6Clinical disorders Axis 7Personality disorders & mental retardation Axis 8General medical conditions Axis 9Psychosocial and environmental problems Axis 10Global assessment of functioning
Drydan-Edwards, R (2008), Posttraumatic Stress Disorder (PTSD). Retrieved 22nd August 2009, http://www.medicinenet.com/posttraumatic_stress_disorder/article.htm Anxiety Australia (2009), Post Traumatic Stress Disorder (PTSD). Retrieved 22nd August 2009, http://www.anxietyaustralia.com.au/anxiety_disorders/post_traumatic.shtml
National Institute of Mental Health (2009), Post-Traumatic Stress Disorder (PTSD). Retrieved 22nd August 2009, http://www.nimh.nih.gov/health/topics/post-traumatic-stressdisorder-ptsd/index.shtml American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC