Post Traumatic Stress Disorder(PTSD) is a disorder that occurs in people who have suffered through a traumatic event. Such as sexual abuse, natural disasters, war, etc. These people then go through three different types of symptoms; the first is called re-experiencing where they relive the event through nightmares, flashbacks and bad thoughts.
Then there’s the second set of symptoms which are called avoidance symptoms where they do things like avoiding an area where the event occurred or somewhere that reminds them of that event, getting a strong sense of guilt, depression, worry or becoming emotionally numb, not being able to remember the event or losing interest in things that they once enjoyed doing. Then there is the third set of symptoms called hyperarousal symptoms which include having angry outbursts, trouble sleeping, being easily startled and feeling on edge(“Post Traumatic Stress Disorder” 1).
PTSD can occur in anyone and it is something that is becoming a major disorder in today’s society with the Iraq/Afghanistan wars that have been going on since 2001. There has been a lot of research done on it to prove that PTSD is actually real and that it is affecting more and more people, especially war veterans, and going untreated. Review of Research: There was an experiment that was done by 7 doctors who have M. D. s and Ph. Ds. They did a random, controlled experiment on a small group of active service members with the goal of comparing which treatment for PTSD has better results, TAU or VR-GET.
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The experiment procedures were approved by the Institutional Review Board and an independent medical monitor. It was conducted at U. S. Navy medical facilities in San Diego and Camp Pendleton and followed all federal and military guidelines in the treatment of Service Members and research participants(McLay 224).
The experiments and patients both were aware of what was going on in the experiment, had to sign consent forms that said they were allowed to leave at any time knowing that they would not receive active duty pay and that they were participating willingly and then the patients signed up for VR-GET or TAU and there was an equal amount of patients in each type of treatment(McLay 224).
The abbreviation TAU means treatment as usual which means that the service members go through normal treatments for PTSD like prolonged exposure, cognitive processing therapy, Eye Movement Desensitization and Reprocessing, substance rehab, inpatient services or a combination of them(McLay 225).
And the abbreviation VR-GET means Virtual Reality-Graded Exposure Therapy which is as it sounds.
It is a virtual reality simulation that allows the patient to experience their traumas and phobias in a controlled environment and also be monitored by equipment that measures their response to their surroundings in the virtual reality they’re experiencing. The therapist during this VR simulation can also increase or decrease the stressing factors of the environment based off the patient’s response to what they’re experiencing(McLay 223).
The experimenters hypothesized that “patients with combat-related PTSD would be more likely to experience clinically significant improvements in VR-GET than treatment as usual(TAU)(McLay 224).
” To participate in the experiment the patients had to have CAPS scores of 40 or higher and then their medical records were reviewed. CAPS is the Clinician Administered PTSD Scale. The experiment was conducted over a 10 week period with a follow up assessment 10 weeks after the experiment ended and it was considered a success if the it showed a clinically meaningful improvement, which means 30% or greater, reduction of PTSD symptoms with CAPS(McLay 224).
They then went through their experiments and were assessed after the 10 week period. The results showed that of all 10 participants who had participated in the VR-GET, seven of them showed a 30% or greater improvement in CAPS and of the 10 who participated in the TAU treatment only one of the returning nine showed a 30% or greater improvement on the CAPS (1 did not show up to complete the post assessment until later)(McLay 226).
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The results show that the VR-GET treatment works better than the TAU treatment by a significant amount.
Though the researchers said that this should also be based off the patient’s needs since everyone responds to treatments differently and that there will probably be no “one-size-fits-all approach” due to the fact previously stated. A research team of 5 that conducted a PTSD survey on soldiers with amputated limbs or spinal injuries in a rehabilitation facility in Sri Lanka. The treatment for soldiers in the war in Sri Lanka is more physically based then mentally and it is a known fact that there is a higher risk of PTSD in soldiers who have been in battle(Abeyasinghe 377).
PTSD is prevalent in about 30% of war veterans, male and female both( Abeyasinghe 377).
The study was one of the first done in Sri Lanka since no one has thought to do it previously and was carried out in 2009. They used a questionnaire that was based on the Diagnostic and Statistical Manual of Mental Disorders; the questionnaire was made based on the Impact of Event Scale and PTSD symptom scale(Abeyasinghe 377).
The questionnaire was translated into Sinhala and it was pre-tested in other injury groups and then from that, they refined the questionnaire to fit their needs and gave that to the spinal injuries and amputees(Abeyasinghe 377).
The research they did was a cross sectional study, which means that they used different people who had similar interests to the study, and then got willing participants to take part in the research. The results showed that of the 96 participants, 40 of them indicated a diagnosis of PTSD(Abeyasinghe 378).
That means that 41. 7% of participants were diagnosed with PTSD and are not being treated for it and would not be if they had not taken the survey to find out.
They did this study with Vietnam veterans and soldiers who went to Afghanistan and found that 30% of those soldiers also had PTSD and were not being treated for it until afterwards also(McLay 379).
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This study shows that even though we give our soldiers the medical attention they need, they are not getting all of it and that should be fixed. There was an experiment done about the medical research done on twins, combat exposed and non-combat exposed, along with comparing previous studies of PTSD to their medical research. They used PTSD patients and a control group.
For the twins they are using the ones who have PTSD and the ones who do not and then comparing their MRIs(Pitman 772).
The MRIs show that the combat exposed twin who has PTSD have an enlarged hippocampal area and that the combat unexposed twin had a high risk factor for PTSD because the twin had PTSD. Their hippocampal area was also enlarged when compared to the control twins who had no PTSD and a low risk factor(Pitman 772).
The article goes through every part of the brain and compares the scans of the combat exposed and combat unexposed twin groups, control and experimental, comparing the area of study, like the prefrontal cortex.
They used previous neuroimaging literature that stated that the prefrontal cortex reduces in size with PTSD and did sMRIs to find that patients with PTSD had a reduced volume in their rostral(pregenual) vmPFC and in the dorsal anterior cingulate cortex(dACC).
Which is the area of the brain that corresponds to Brodmann area and can also be called anterior mid-cingulate cortex(Pitman 772-773).
It goes through every biological aspect you could think of and speculates off of the research previously done to the medical tests they have conducted to show how PTSD affects the brain, hormones, genes, and animal studies.
Then their conclusions at the end to tell you how this will help future medical treatments of PTSD. There was a study done about how the medical drugs that have been developed for PTSD are very lacking in the ability to help PTSD patients. Records show that patients who receive pharmacological treatments like SSRIs paroxetine and sertraline barely ever exceed 60% and even less patients(20-30%) achieve clinical remission(Bailey 221).
Even placebo-trials of other medications for PTSD have failed and recent studies of medications that are approved have failed to show desired results in patients(Pitman 222).
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The article is basically going over the effects of the drugs that are usually used to treat PTSD like noradrenergic, serotonergic, endogenous cannabinoid and opioid systems along with hypothalamic-pituitary adrenal (HPA) axis and then from figuring out what works with these and what does not, a possible future pharmacological intervention that could actually work and show results(Pitman 222).
They then go into detail of each drug, explaining what it is made up of and how it does and does not work in relation to PTSD, including studies that have been done previously, charts, references to other works and explanations for the large words and confusing terminology. The conclusion of the article states that biological markers alone are not sufficient by themselves, especially since treatment is limited to symptom management rather than fixing the biological cause(Pitman 227).
Since there is not one drug that works specifically for PTSD, by using existing knowledge and research they can come up with treatments that relate to PTSD(Pitman 227).
To conclude, there is a lot of research done on PTSD, statistics, experiments, biological aspects, pathophysiological aspects and so much more.
PTSD is a very new field of study in medicine and it is not known where it comes from exactly, whether its genes or just the body’s coping mechanism for events to stressful for the mind but either way it is something that is increasing in the world’s population with wars, natural disasters, physical/sexual abuses, etc. and it needs to be addressed. More and more people are suffering without a way to fix it and it is taking a toll on the mental health of the population. Works Cited