Criteria And Study Subject Recruitments

Post-traumatic stress disorder (PTSD) is a relatively new diagnosis that was associated with survivors of war when it was first introduced. Its diagnosis was met largely with skepticism and dismissal by the public of the validity of the illness. PTSD was only widely accepted when it was included as a diagnosis in 1980 in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) of the American Psychiatric Association. PTSD is a complex mental disorder that develops in response to exposure to a severe traumatic event that stems a cluster of symptoms. Being afflicted with the disorder is debilitating, disrupting an individual’s ability to function and perform the most basic tasks.

Between February 2001 and April 2003, many were completed by approximately 9,282 Americans, 18 years of age or above, completed a survey that was conducted by The National Comorbidity Survey Replication (NCS-R). According to The National Comorbidity Survey Replication study, 5,692 Americans were diagnosed with PTSD. However, this research used the DSM-4 criteria. It was estimated that the lifetime prevalence was about 6.8% for Americans in young adulthood. This was a jump from the previous year at 3.5%. The lifetime prevalence for women was higher, at 9.7%, than it was for men at 3.6%. “Kessler, R.C., Berglund, P., Delmer, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005).”

In this scenario, the independent variable is the type of treatment and the values are the treatment groups. The dependent variables are the patient’s measurable PTSD symptoms, including frequency of dissociative reactions, recurrent distressing dreams, negative alterations in cognitions and mood, and marked alterations in arousal and reactivity (American Psychiatric Association, 2013). The demographic variables in this study are age and ethnicity. The control variables are gender, geographic location, and PTSD.

The first type of Treatment is called Cognitive behavioral therapy or CBT. Research says that this is the best type of treatment and counseling for anyone diagnosed with PTSD. Cognitive behavioral therapy is used to help the veteran think differently about their thoughts or feelings from the past. The main goal by the therapist is to help the veteran find out what past events or flashbacks correlate with the veteran’s thoughts that make the symptoms of PTSD occur. Many times, the veterans will blame themselves for a decision they made but the therapist will walk them through on how it was not their fault. Cognitive Behavioral therapy can last for three to six months. Although to some people it may seem that CBT might be the best type of treatment, it does not always work. One reason why it might not work is because the therapist may like the experience and education. The therapist may be qualified but sometimes, the therapist may fail at connecting with patient. The connection that is missed by some therapists and patients can simply occur by the therapist not having all the knowledge about all the situations soldiers face when they go to war. Soldiers struggle with their therapy if they feel that the therapist who is helping them does not have the knowledge about the battlefield or the difficulties of war itself. The relationship of the therapist and veteran can also play a major role on the effectiveness of the therapy. Some soldiers may struggle with feeling comfortable with their therapist because they are sensitive and emotional. Sometimes veterans struggle with this therapy if they cannot develop a relationship with their therapist. Another factor that can affect the effectiveness of CBT is the timing. Sometimes three to six months is not enough to show long term effectiveness of the therapy. Another treatment option is exposure therapy.

Two selective serotonin reuptake inhibitors (SSRIs), paroxetine and sertraline, have been approved by the FDA for the treatment of PTSD. However, the results of the effectiveness of pharmacology in double-blind, placebo controlled studies were not greater than PE and CPT or they were insignificant (Peterson et al., 2011).

I will be collaborating with The National Institute of Mental Health for the funding of the research project. The research will attempt to identify what factors determine whether someone with PTSD will respond well to Cognitive Behavioral Therapy (CBT) intervention, aiming to develop more personalized, effective and efficient treatments. The mission of this project is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure (National Institutes of Health, 2013).

The patients generally come to the clinical settings when secondary stage psychological problems surface. Therefore, early detection of symptoms and impactful intervention is the key to effective management of PTSD [27].

Although American service members have felt the lasting effects of combat throughout the history of the nation, it was not until 1980 that Post-Traumatic Stress Disorder was formally added to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. Once referred to as “irritable heart” or “shell-shock,” PTSD made its way into the national spotlight in the years following the wars in both Iraq and Afghanistan due to U.S. military members having difficulty reintegrating into civilian life. High rates of suicide, depression, and elevated levels of violent crime within the veteran community made the need to find an effective treatment of this disorder a top priority for the Veterans Health Administration. While it is widely accepted by medical professionals that there is no single, definitive cure for PTSD, many different methods have been cultivated within the past 15 years that make coping with it an easier process; some to a greater extent than others. While medications, namely antidepressants and benzodiazepines, usually find themselves at the forefront of any discussion regarding mental debilitation, they are not a one-size-fits-all solution to the problems that combat veterans face. As this particular disorder is attached to a certain memory or traumatic occurrence, alternative methods of rehabilitation such as Cognitive Behavioral Therapy (CBT) and Prolonged Exposure (PE) have also shown promise in

Participants will be collected different PTSD clinics to avoid biases. Patients will be collected in groups each at a time.

“People with PTSD experience three different kinds of symptoms. The first set of symptoms involves

Nevertheless, limitations to the successes of these treatments do exist. “Some studies have estimated that of the general population with PTSD diagnoses, only 49.9%

If the patients scored a 44 or greater on their PTSD checklist then they would then complete a baseline assessment. From there if the patient met the PTSD diagnostic standard they were randomly put into 1 of 3 treatment conditions: Integrated Cognitive Behavioral Therapy(ICBT) plus Standard Care(SC), Individual Addiction Counseling(IAC) plus SC, or just SC by itself. Instruments that were used were urine drug screens. These were used to confirm that the patient was actively using a substance. Another tool used was the one step Multi-Drug Screen Test card that has an Integrated iCup. This test is used to test for many drugs recent in the patient such as: cannabis, amphetamine, opiate, etc. The Timeline Follow Back(TFLB) Method and ASI were also used. The TFLB is a well-organized interview that is like a self-report, that is used to obtain a patient’s substance intake for the former 90 days. The Clinician Administered PTSD Scale (CAPS), is a diagnostic interview used to measure PTSD. For the patient to meet the criteria the CAPS total score must be equal to 44 or greater. The patient must also report symptoms such as numbing, hyperarousal, etc. Moderate PTSD scores were between 44 and 64. CAP scores that were equal to 65 or greater was considered severe PTSD. ASI was used to examine psychiatric problem severity. Things such as chi-squares and T-tests were used to evaluate the differences in baselines in

PTSD criteria A and B. Josh meets all of the criteria for PTSD as outlined in the DSM-V (American Psychiatric Association, 2013, pp. 272-272). Criterion A refers to exposure to a traumatic event. Josh meets criteria A1, A2, and A3 (only one of four is required to meet criterion A) because he both witnessed firsthand the car accident that claimed the life of his fiancée, and she died tragically in his arms. Josh meets criterion B1 of the disorder because of his vivid, recurring, involuntary, and deeply distressing

The patients used it this design were outpatients referred in 1992 through 1995 by professionals, Victim Support, police, ambulance, fire services, and even the subjects themselves. The criteria that had to be met in order for the subjects to be used in this study were as followed: PTSD for 6 or more months; age of 16 to 65 years; and absence of melancholia or suicidal intent, organic brain disease, past or present psychosis, antidepressant drug (unless the patient had been receiving a stable dose for 3 or more months); and diazepam in a dose of 10 mg/d or more or equivalent, ingestion of 30 or more alcohol units a week, and past exposure or cognitive therapy for PTSD (Marks et al., 1998). The therapist used a procedure manual and 4 treatment manuals which covered each session in each treatment condition. The sessions were audiotaped and each individual session lasted either 90 minutes or 105 minutes in Exposure Combined with Cognitive Restructuring (EC) therapy.

1.3,NAD, UNIT13, Evaluate different approaches that may be used to ensure the selection of the best individuals for work in health and social care.