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Diagnosis and Treatment of Trauma and Stressor-Related Disorders

Introduction

Mental health is crucial for the overall well-being of an individual. Stress-related disorders contribute negatively to people’s health outcomes, and therefore, early diagnosis of psychiatric disorders and the initiation of proper treatment plans are critical. One of the most common stress and trauma-related conditions is Post-Traumatic-Stress-Disorder, commonly abbreviated as PTSD (Luftman et al., 2017). Its occurrence or manifestation is usually triggered by one’s involvement in a horrifying event that results in severe anxiety, nightmares, and flashbacks. This paper provides a comprehensive review of the disorder’s background, the importance of appropriately diagnosing PTSD, and the recommended treatment approaches.

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Background and Prevalence Rates of PTSD

PTSD is a psychiatric health condition affecting persons who have encountered, witnessed, or experienced traumatic and horrendous events, including fatal accidents, life-threatening incidents, natural calamities, terrorist attacks, violent wars, sexual abuse, or rape. Research by psychiatrists indicates that PTSD’s occurrence is independent of race, ethnicity, cultural background, and age level. In the United States, the rate of PTSD among the adult population is about 3.5% annually; approximately one in eleven adults in the U.S is diagnosed with PTSD at one point in their lifetime (Henkelmann et al., 2020). PTSD has been associated with a significantly high incidence among women than their counterparts. Besides, in the United States, the racial-ethnic dynamism regarding PTSD indicates that African Americans, Latinos, and Indian Americans have increased PTSD prevalence rates compared to other ethnic groups (Lehavot et al., 2018). This, therefore, highlights that although PTSD is typical in each racial group, black Americans record high incidence rates.

PTSD is also common among females, children, and experts within the military. The prevalence rate for PTSD among women in the United States stands at 10- 12%, whereas in school-going children across the U.S., the rate is at 34.1% (Henkelmann et al., 2020). Furthermore, regarding the military personnel, the prevalence rate ranges from 17- 31% for active-duty personnel (Dückers et al., 2016). Persons diagnosed with PTSD often experience deep, disturbing, and horrifying thoughts, as well as emotional feelings linked to past terrifying and traumatizing occurrences. Nightmares and flashbacks may be an avenue to relive the horrendous encounters of these happenings (Pan et al., 2018). A person with PTSD typically registers feelings of sadness, frustration, anger, and detachment among other patients.

Diagnosis for PTSD and its Importance

As indicated earlier, the timely diagnosis of PTSD is crucial for the attainment of favorable health outcomes and the betterment of patients’ psychological well-being. To ensure the effective diagnosis of PTSD, practitioners typically use the DSM-5 diagnostic criteria. This approach applies to children aged six and above, adolescents, and adults. The above-mentioned diagnostic approach aims to assess:

  • An individual’s exposure to threatened or actual death, sexual violence, or severe injury in either of the following ways: 1. Witnessing the unfolding of the event’s impacts on other individuals. 2. Encountering the traumatic occurrence directly. 3. Learning that the traumatic happening has occurred to a close member of the family, and 4. Experiencing extreme or recurrent exposure to the details of an aversive traumatic event.
  • The presence or manifestation of one or more intrusion symptoms or etiologies linked to the traumatic event following its occurrence. These symptoms include intrusive, involuntary, and repeated distressing memories of the incident, recurrent stressing dreams whose effect or content are associated with the life-threatening episode, and dissociative reactions, including flashbacks (“DSM-5 criteria for PTSD,” 2019). Other clinical manifestations include prolonged or intense mental distress upon the exposure to external or internal cues that mimic a feature of the traumatic happening and psychological responses to cues that resemble or symbolize the life-threatening episode’s element.
  • Persistent or continuous avoidance of the traumatic episode’s stimuli, which begins following the occurrence of the life-threatening event. This may be evidenced by one’s attempt to avert stressing thoughts, memories, or feelings closely linked to the happening (“DSM-5 criteria for PTSD,” 2019). One may also try to isolate from the external triggers which arouse stressing thoughts memories or feelings associated with the occurrence.
  • Negative alterations in mood and cognition are connected with the traumatic episode which begins or worsens following the occurrence of the life-threatening event. This may be exhibited by two or more of the following clinical presentations: one’s incapacity to recall a significant element of the event, as well as exaggerated and persistent negative anticipations of perceptions about oneself, the world, or others (Brainline, 2019). Other symptoms include distorted cognitions regarding the impacts or causes of the happening, recurrent adverse emotional state, estrangement or detachment from others, and the incapacity to feel positive emotions.
  • Noticeable alterations in reactivity and alterations connected to the traumatic episode which begins and worsens following the event’s happening. This can be demonstrated by two or more clinical manifestations, including sleep disturbance, concentration issues, hypervigilance, self-destructive or reckless deportments, angry outbursts, and irritable behavior.
  • The duration of these clinical manifestations, which should be more than a month.
  • Whether the disturbance triggers clinically considerable impairments in different areas of operation or functioning, including occupational and social areas, as well as distress.
  • Whether the disturbance is not ascribed to a substance’s physiological effects.

The majority of persons develop PTSD symptoms within a time frame of about three months from the precise moment that the horrendous event took place. Women, children, and military personnel are commonly affected by PTSD based on the reports of the prevalence rates per cohort (Dückers et al., 2016). The timely and accurate diagnosis of the condition can be instrumental in improving the efficacy of therapies. It also plays a crucial role in minimizing or avoiding long-term complications linked to the disease, which include suicidal thoughts or actions, eating disorders, issues related to alcohol and drug use, anxiety, and depression (Creech & Misca, 2017). Developing a precise diagnosis is also crucial in minimizing the likelihood of errors in inpatient assessments and their adverse events.

Treatment Approach and Prevalence Rates for PTSD

Two approaches can effectively be used to treat PTSD, in particular, medication and psychotherapy. Psychotherapy can take a long or short-term, depending on the psychologist’s judgment (Pan et al., 2018; Watkins et al., 2018). The psychotherapy model has the following objectives regarding treatment: enhancing expression of the symptoms, teaching coping skills, and enhancing self-esteem. Therapies for PTSD fall under the precincts of cognitive-behavioral therapy (Feducia et al., 2018). The therapist focuses on the alteration of the thought patterns and understanding the source of the trauma or fear. For the medication aspect, a clinical psychologist may consider the use of the following drugs on a patient: Venlafaxine (Effexor), Fluoxetine (Prozac), Sertraline (Zoloft), and Paroxetine (Paxil) (Krystal et al., 2017). The above-mentioned therapeutic approaches can help minimize the disorder’s symptoms and improve the patient’s life quality and health outcomes.

Conclusion

PTSD is a primary psychiatric health condition in persons who have encountered, witnessed, or experienced traumatic and horrendous events such as fatal accidents, life-threatening incidents, and natural calamities. Persons diagnosed with PTSD often experience deep, disturbing, and horrifying thoughts and emotional feelings associated with the past terrifying and traumatizing occurrence. To ensure the effective diagnosis of PTSD, specialists typically use the DSM-5 diagnostic criteria. In practice, two strategies can be effectively used in treating PTSD, including medication and psychotherapy.

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References

Creech, S. K., & Misca, G. (2017). Parenting-with-PTSD: A review of research on the influence of PTSD on parent-child functioning in military and veteran families. Frontiers in Psychology, 8, 1–8. Web.

Dückers, M. L., Alisic, E., & Brewin, C. R. (2016). A vulnerability paradox in the cross-national-prevalence of post-traumatic stress disorder. The British Journal of Psychiatry, 209(4), 300-305. Web.

DSM-5 criteria for PTSD (2019). BrainLine. Web.

Feduccia, A. A., Mithoefer, M. C., Jerome, L., Holland, J., Emerson, A., & Doblin, R. (2018). Response to the consensus statement of the PTSD Psychopharmacology Working Group. Biological Psychiatry, 84(2), e21-e22. Web.

Henkelmann, J. R., de Best, S., Deckers, C., Jensen, K., Shahab, M., Elzinga, B., & Molendijk, M. (2020). Anxiety, depression, and post-traumatic stress disorder in refugees-resettling in high-income countries: systematic-review and meta-analysis. BJPsych Open, 6(4) 1–7. Web.

Krystal, J. H., Davis, L. L., Neylan, T. C., Raskind, M. A., Schnurr, P. P., Stein, M. B., & Huang, G. D. (2017). It is time to address the pharmacotherapy crisis of post-traumatic stress disorder: a consensus statement of the PTSD psychopharmacology working group. Biological Psychiatry, 82(7), e51-e59. Web.

Lehavot, K., Katon, J. G., Chen, J. A., Fortney, J. C., & Simpson, T. L. (2018). Post-traumatic-stress-disorder by gender and veteran status. American Journal of Preventive Medicine, 54(1), e1-e9. Web.

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Luftman, K., Aydelotte, J., Rix, K., Ali, S., Houck, K., Coopwood, T. B., & Davis, M. (2017). PTSD in those who care for the injured. Injury, 48(2), 293-296. Web.

Pan, X., Kaminga, A. C., Wen, S. W., & Liu, A. (2018). Catecholamines in post-traumatic stress disorder: A systematic review and meta-analysis. Frontiers in Molecular Neuroscience, 11, 1–14. Web.

Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 1–20. Web.

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