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Post Traumatic Stress Disorder

ptsd

What is PTSD . . . The History and Evolution is Convoluted

PTSD (Post Traumatic Stress Disorder) has a complex and complicated history. In addition, it has a complex demographic and has complex treatment regimens. Furthermore, new treatments are presented and experimented with in both military and civilian environments, aimed at conquering a variety of different symptoms of PTSD among a diversity of demographics.

post traumatic stress disorderWhile PTSD is most commonly associated with military, war-zone veterans, it is now recognized as the same disorder seen in many civilian situations, those who experience any traumatic event in his/her life, i.e., sexual abuse, domestic violence, domestic terrorism, natural disasters, that results in some significant change in the brain. The prevalence and accounts of PTSD are also affected by such demographics as race, gender, sexual orientation, and age.

PTSD, while exhibited in a broad spectrum of the population, has some very specific behavioral identifications rendering the diagnoses more specific, making obsolete the more broad-brush psychological disorder that began its history.

A PTSD diagnosis now recognizes its cause as the result of an event the individual suffered, rather than a personal weakness — a significant distinction that works to remove the stigma of the PTSD diagnosis, especially for proud military veterans.

The four identified behaviors accepted benchmarks by both military and civilian therapists:

  1. Re-experiencing, or reliving the traumatic event

  2. Actively avoiding people, places, or situations that remind the patient of the traumatic event

  3. Hyperarousal

  4. Negative thoughts and beliefs

post traumatic stress disorderIt’s important to mention, these symptoms, regardless of the trauma of their origin, will likely result in the diagnosis of PTSD. PTSD diagnoses extend far beyond the military—affecting about eight million American adults in a given year.  And PTSD is not unique to adults –

Children are a Growing Demographic of this Diagnosis

The term “posttraumatic stress disorder” came into use in the 1970s primarily due to the detection of veterans of the Vietnam War.  Prior to this term, such conditions were referred to as shell shock, a term originally used to describe soldiers who were involuntarily shivering, crying, fearful, and had constant intrusions of memory. It is not a term used in psychiatric practice today but is still common in everyday expression of our population according to Psychology Today.

Combat Stress Reaction

Over the years and through various wars, the term has evolved from shell shock, battle fatigue, soldier’s heart, CSR (Combat Stress Reaction), and, in current vocabulary, to post-traumatic stress disorder, or PTSD.  There is a movement now including military officers and psychiatrists taking a serious look at changing the name slightly to something that carries less of a shame of weakness by the inclusion of the word ‘disorder’.  The favored new moniker: post-traumatic stress injury.  Military officers and some psychiatrists say dropping the word “disorder” in favor of “injury” will reduce the stigma that renders troops hesitant to seek treatment. There is an inherent fear among military first responders, pilots, doctors, etc.  who fear being stripped of their duties, and those seeking life-time profession in the military fear that a diagnosis with the word ‘disorder’ on their personal records could also hinder their future advancement and promotions. Source ABC News

The VA defines PTSD as “the development of characteristic and persistent symptoms along with difficulty functioning after exposure to a life-threatening experience or to an event that either involves a threat to life or serious injury.”

History, Diagnostic Criteria, and Epidemiology

post traumatic stress disorderStress producers and traumatic events have also evolved over time. Stressors experienced by 1990–1991 Gulf War combat troops included uncertainty about possible exposures to chemical and biologic weapons, environmental exposures (such as to oil-well fire smoke and petroleum-based combustion products), incomplete knowledge of enemy troops, the harsh desert climate, separation from family, and crowded and difficult living conditions (for example, lack of privacy, infrequent access to hot water and laundry facilities, and constant vigilance for scorpions and snakes) Source: Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment.

Additional significant differences between the current conflicts and prior engagement in the Middle East are the increasing number of insurgent attacks in the form of suicide bombs and car bombs, improvised explosive devices, sniper fire, and rocket-propelled grenades. Attacks are difficult to predict, often occurring in civilian areas where identification of enemy combatants is sometimes nearly impossible. This is an enormous difference from the environment of past wars.  Troops in wars past knew who the enemies were and where they were and could fight across visible, identifiable battle lines.  Now there are no lines, and the enemy is invisible and seemingly infinite, representing a relentless and continual threat.  Troops have no escape from the presence of the enemy.

Currently, 15.5% of all military personnel and nearly one-fourth of Army reserves are women

post traumatic stress disorderIn addition to the obvious differences, and consequent prevalence of PTSD within military personnel, there are other demographics of the military (and therefore veteran) population that have also changed since the Vietnam War. The female-to-male ratio has increased; only 0.2% of service members in Vietnam were women compared with 12.7% of the deployed force in comparison to later Middle East wars. Currently, 15.5% of all military personnel and nearly one-fourth of Army reserves are women. The racial and ethnic composition of the military has also evolved since the 1960s: 87% of military personnel in Vietnam were non-Hispanic white compared with 75% of current personnel. Source: Treatment for Posttraumatic Stress Disorder in Military and Veteran …

National Public Health Problem

While many important advancements have been made over the past few decades in understanding and treating symptoms of PTSD, the rising number of American veterans who suffer from the disorder continues to be a serious national public health problem.

Please subscribe to our blog as we will bring you new information that addresses the treatment of PTSD. In addition, to how it has evolved from very basic psychological treatment, then paired with pharmacological treatments, and today evolving into state-of-the-art treatments for PTSD.  The VA is training its clinicians to use various cognitive therapies, including  the rewind technique, eye movement desensitization reprocessing (EMDR) and emotional freedom therapy (EFT, colloquially known as ‘tapping’) — for which claims of success bordering on the miraculous have been made, in the treatment of PTSD (https://www.hgi.org.uk/resources/delve-our-extensive-library/anxiety-ptsd-and-trauma/ptsd-why-some-techniques-treating-it …

VA’s National Center for PTSD was created in 1989 by an act of Congress and celebrated its 25th anniversary in 2014

 

 

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