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Investigating Post-Traumatic Stress Disorder

Summary

Most people experience traumatic events during their lifetime. For the first time, the phenomenon of post-traumatic stress disorder was examined among the participants of the different wars. Over the last decades, a certain amount of studies of this type of disorder was presented in the literature. The topic to be developed is the incidence of the post-traumatic disorder and the effective ways of its treatment. For the investigation, I used various literature sources that define the problem and give reliable information about its specifics.

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Methods

Literature search strategy

Scientific articles, books, and studies are the best sources of gathering different views on the problem and its factors. Before the beginning of the searching process, I defined the component issues and the primary keywords in the chosen topic. I conducted a literature search on relevant resources, such as PubMed, Phoenix University Library, and PsycINFO Proquest database. Besides, I used Google Scholar and a focused Internet retrieval to find scholarly articles exploring the issue. The filters were applied to limit the search to sources in the English language and restrict the data range of publications to not prior to 2000.

Inclusion and Exclusion criteria

For the selection of appropriate studies, I examined the abstracts and evaluated the full texts, focusing on their credibility and correspondence to the research question.

The publications were excluded if they were published prior to 2000, didn’t rely on proper information sources, or gave invaluable conclusions.

Literature review

Tens of publications were identified during the literature search. Those of them, which correspond to the main questions of the topic and present reasonable information, were chosen for investigation. For the exploration of the nature of the phenomenon of post-traumatic stress disorder and its incidence, I concentrated on the analysis of the appropriate studies published in respected scientific journals.

Investigating the incidence of post-traumatic stress disorder

The incidence of post-traumatic stress disorder is usually investigated in the context of definite traumatic events, e.g. wars, terrorist acts, etc. Kang, Lee, Mahan, Murphy, and Natelson (2002) presented a study examining the prevalence of post-traumatic stress disorder syndrome among Gulf War veterans (p.141). The study population included 15.000 Gulf veterans and the same number of non-Gulf veterans. The study subjects were interviewed with the help of a self-administered questionnaire. The investigation gives a full image of tendencies in experiencing this type of disorder among the participants of the war. The data reported in the survey demonstrates a strong connection between the incidence of post-traumatic stress disorder and stress intensity. This fact explains the higher rates of post-traumatic stress disorder among Gulf War veterans, in comparison with the participants of other wars.

Burgess, Creamer, and McFarlane (2001) stated a high prevalence of post-traumatic stress disorder in the Australian community (p. 1237). Their study proved the fact that the gender factor influences the prevalence of the syndrome. But it didn’t support other investigations in defining this factor as a significant one. The study reports a higher incidence of such types of disorders among unmarried persons. It also shows the relation between the age of participants and the rates of deviation. Sex assaults are described as the strongest factors of risk in the development of severe post-traumatic stress disorder.

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Another report used to explore the problem of the issue is the one conducted in San Diego. McCahill, McQuaid, Pedrelli, and Stein (2001) have studied the specifics of the development of post-traumatic stress disorder among primary care patients (p.1250). The professors examined the nature of traumas and their contribution to the development of the disorder. Nearly four hundred primary care patients went through a psychiatric syndrome examination. Within fourteen days after the screening, one hundred thirty-two participants were interviewed by the specialists. According to the results, nearly half of the patients who had experienced traumas got post-traumatic stress disorder. The investigation has also proved the fact that the influence of assaultive events is much stronger than the impact of non-assaultive traumas.

Galea, Nandi, and Vlahov (2005) made a great contribution to the exploration of the incidence of post-traumatic stress disorder after disasters (p. 84) by documentation of the results of their study. The scientists found out that witnesses of man-made or technological disasters are more likely to have a deviation than the witnesses of natural disasters. It can be explained by the fact that most studies concerning human-made disasters focused on the direct victims. The investigations of natural disasters mostly relied on the evidence given by people who were affected by the event only potentially.

Investigating the ways of treatment for post-traumatic stress disorder

The exploration of the possible medical treatment for post-traumatic stress disorder was made through the analysis of peer-reviewed articles and books which examine the issue.

Barlow’s handbook is a popular and respectful source of knowledge for students and practitioners. The author presents a large amount of information about the diagnosis, prevalence and theoretical models of post-traumatic stress disorder. He also concentrates on the description of assessment and treatment. There are four accepted forms of therapy (Barlow, 2007, p.76). The stress inoculation technique is described by the author as an adaptable one. Exposure therapy is regarded as a complicated and sometimes insufficient way of treatment. Cognitive techniques include using personal diaries and supporting patients to challenge their thinking about the traumas. Another technique includes combination treatments and eye movement desensitization and reprocessing. Barlow describes each of the forms of therapy in detail and provides examples of the related investigations. The case of “Tom” reveals the specifics of “the psychopathology associated with PTSD in all its nuances” and demonstrates “a very personal account” of its influence (Barlow, 2007, p. 65).

To explore the accepted ways of treating post-traumatic stress disorder with the help of medications, I used the informative article published in The New England Journal of Medicine. Yehuda (2002) states the importance of the appropriate strategy of the primary care providers’ behavior for the proper treatment and support of the patients suffering from the deviation (p. 112). The author believes that clinicians can help the patients to understand the need for treatment by providing “a noncritical ear” and persuading the patients they are not alone (Yehuda, 2002, p.112). An overview of the most popular medications used for treating the disorder is presented in the article. Serotonin-reuptake inhibitors are regarded as the most appropriate ones, as they are safer than other psychotropic medicines. The author presents an algorithm for using different medications due to different results of primary assessment and treatment. She also emphasizes the lack of research in this field and the prominent need for further investigation, in order to establish the most effective way of medical treatment for such types of disorders.

Patient-related factors

Patient-related factors are the basis of the analysis of post-traumatic stress disorder. They influence the choice of method of treatment. Besides, the well-timed analysis of these factors results in better communication and trust between patients and clinicians.

Patient-related factors include gender, age, origin, temperament, level of education, the field of work, family status, etc. They determine the specifics of the patient’s perception of the trauma experience. Relying on the analysis of these factors, an experienced healthcare worker can find a proper approach for establishing confiding relationships and providing the most suitable technique of treatment.

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System-related factors

System factors play a vital role in the assessment and treatment of post-traumatic stress disorders by primary care practitioners. Only those clinicians who have established strong relations with mental health and social services can provide adequate care for patients with the deviation. The possibility of consulting mental health specialists creates a better ground for early recognition and further treatment of the disorders. Community services can also make a great contribution to the improvement of primary care clinicians’ work with the patients suffering from such types of deviations. Another important factor is the availability of educational programs for patients and clinicians. This factor has a great influence on the quality of relations between patients and healthcare workers. It also gives a possibility of broadening the limited treatment knowledge among medical workers.

Gaps in the literature

After monitoring the available literature, I came to the conclusion that the issue of post-traumatic stress disorder is not well-explored enough.

Most of the investigations analyzing the incidence of the deviation rely on the studies conducted many years ago. There is not enough data on this topic, and even the accessible studies are mostly outdated. My attempts to find the research that collects the results of main investigations and systematizes them for further analysis were not successful. There is no research comparing post-traumatic stress disorder rates in different countries, depending on the level of their economic development or other important factors.

The scholarly articles examining the ways of treatment for post-traumatic stress disorder are also distinctly shallow. Though there is a big amount of sources describing officially accepted methods of treatment, the data on the level of efficacy of each of these techniques are difficult to be found. There are also quite a few studies analyzing the effectiveness of treating the disorders with different types of medications.

From the above reasoning, it is clear that the present number of studies, conducted to explore the issue, is not enough for a full understanding of the nature of the problem and its specifics. Literature sources present a description of the different aspects of post-traumatic stress disorder, but do not give enough evidence and data related to the topic.

In my opinion, only stimulation of further investigations can improve the deficiency found. The topic is very urgent as most people are exposed to traumas during their lifetime. Therefore, a search for an optimal set of methods of treatment for post-traumatic stress disorder is of vital importance. The promotion of the issue among scientists will lead to the appearance of new investigations. It can help to optimize and modernize the existing methods and imply innovative ideas.

Only a complex approach to the studying of post-traumatic stress disorder can bring significant results and improve the quality of care provided for patients with such types of deviations.

References

Barlow, D. H. (2007). Clinical handbook of psychological disorders: A step by step treatment manual (4th ed.). New York, USA: Guilford Press.

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Burgess, P., Creamer, M., & McFarlane, A. C. (2001). Post-traumatic stress disorder: findings from the Australian National Survey of Mental Health and Wellbeing. Psychological Medicine, 31(7), 1237-1247.

Galea, S., Nandi, A., & Vlahov, D. (2005). The epidemiology of post-traumatic stress disorder after disasters. Epidemiologic Reviews, 27(1), 78-91.

Kang, H. K., Lee, K. Y., Mahan C. M., Murphy, F. M., & Natelson, B. H. (2003). Post-traumatic stress disorder and chronic fatigue syndrome-like illness among Gulf war veterans: A population-based survey of 30,000 veterans. American Journal of Epidemiology, 157(2), 141-148.

McCahill, M. E., McQuaid, J. R., Pedrelli, P., Stein, M. B. (2001). Reported trauma, post-traumatic stress disorder and major depression among primary care patients. Psychological Medicine, 31(7), 1249-1257.

Yehuda, R. (2002). Post-traumatic stress disorder. The New England Journal of Medicine, 346(2), 108-114.

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