What is known
Traumatic injury is a major contributor to total global burden of disease, and has a serious impact on health and quality of life. Each year in the US, approximately 2.5 million individuals incur injuries so severe that they require acute care hospital admissions (Bonnie et al., 1999). Richmond et al. (2002) found that 90% of a sample of seriously injured older adults survived, which indicates that outcomes beyond survival—such as acute stress reactions and the potential to develop PTSD must be evaluated and addressed for this patient population in the clinical setting. Adults who sustain serious injuries may experience acute stress reactions immediately following the event, and during and after inpatient hospitalization, and
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Zatzick et al., (2008) found that more than 20% of injured trauma survivors across the US develop symptoms consistent with a PTSD diagnosis 12 months after acute care in-patient hospitalization. Consensus guidelines from the National Institute of Mental Health identified seriously injured trauma survivors as a group at high risk for development of PTSD and related comorbid conditions (National Institute of Mental Health, 2002). In addition to the potential of the actual injury to cause traumatic stress, trauma patients may already have other risk factors for PTSD including low socioeconomic status, presence of mental illness, history of combat exposure, childhood neglect or abuse, sexual assault, or previous trauma (Shalev et al., 1994; Brewin et al., 2000). The experience of post-injury hospitalization has also been identified as a potential risk factor for development of PTSD. Several studies found that acute care patients requiring intensive care unit (ICU) admission, intubation, and mechanical ventilation are at risk for development of PTSD (Shaw et al. 2004; Cuthbertson et al., 2004; Kapfhammer et al. 2004; …show more content…
These adaptive mechanisms can become maladaptive if unresolved after precipitating events have passed, leading to interferences in emotional regulation (Liston, McEwen, & Casey, 2009; Juster et al., 2011). Imaging studies show alterations in the brain structures that assist in regulation of the stress response—the amygdala, hippocampus, and prefrontal cortex—due to prolonged exposure to stress (Carrion et al. 2010; Rao et al. 2010). The over activation of this fear circuitry in the brain can lead to distorted processing, contributing to depression (Thienkrua et al., 2006; Neria, Besser, Kiper, & Westphal, 2010; Rao et al., 2010), anxiety (Derryberry and Reed, 2002; Goldin et al., 2009; Graham and Milad, 2014), and mood impairments (Kobasa, 1979; Linehan, 1993; Haller and Miles, 2004). These cognitive changes can also contribute to insomnia, chronic pain, addictive disorders, impairment of immunity, and development of coping mechanisms such as smoking, use of alcohol or drugs, overeating, and other survival mechanisms (Raja, 2012). The allostatic load of a chronically over-activated hypothalamus-pituitary-adrenal system can lead to development of comorbid health conditions such as cardiovascular disease,
The interviewee is asked to identify a “target” trauma, or index trauma, to link the symptoms with, however it can also be utilized to assess symptoms of any interviewee identified trauma (V. This version of the CPSS-I-5 assesses symptoms occurring only in the past month (Foa & Chapaldi, 2012). The CPSS-I-5 differs from the CPSS-SR (or Child PTSD Symptom Scale-Self Report) in that the CPSS-I-5 is completed in an interview format where the interviewer reads the questions out loud to the client versus the CPSS-SR where the client fills it out independently. The assessment yields a total symptom severity score ranging from 0-80, and a total severity-of-impairment score ranging from 0-28 across 7 domains (Foa et. al., 2001). On both CPSS-I and CPSS-SR, receiving a score of 0-10 results in a below threshold score of PTSD symptoms, 11-15 results in a subclinical-mild score of PTSD symptoms, 16-20 results in a mild score of PTSD symptoms, 21-25 results in a moderate score of PTSD symptoms, 26-30 results in a moderately severe score of PTSD symptoms, 31-40 results in a severe score of PTSD symptoms and 41-51 results in a score of extremely severe symptoms (Foa et. al., 2001). Both the CPSS-I and CPSS-SR have displayed good to excellent reliability and validity (Gillihan et al., 2013). One-week test-rest reliability was assessed for CPSS-SR and received a reliability score of r=.86. CPSS-I scores was also excellent (r = .87) (Gillihan, Et. Al., 2013). Both the CPSS-SR and the CPSS-I demonstrated symptom based diagnostic agreement of 85.5% (Gillihan, Et. Al.,
At least 50% of all adults and children are exposed to a psychologically traumatic event (such as a life-threatening assault or accident, humanmade or natural disaster, or war). As many as 67% of trauma survivors experience lasting psychosocial impairment, including post-traumatic stress disorder (PTSD); panic, phobic, or generalized anxiety disorders; depression; or substance abuse.(Van der Kolk, et al, 1994) Symptoms of PTSD include persistent involuntary re-experiencing of traumatic distress, emotional numbing and detachment from other people, and hyperarousal (irritability, insomnia, fearfulness, nervous agitation). PTSD is linked to structural neurochemical changes in the central nervous system which may have a direct
Emergency rescue personnel witnessed the loss of loved ones, furthermore during recovery and rescue efforts they were limited in the amount of debriefing and clinical mental support they received. Priorities at the time focused on saving lives, while mental deterioration was taking place in many simultaneously. “A study published in the Mount Sinai Journal of Medicine found a 71.8% prevalence of PTSD among exposed first responders as opposed to 51.4% among their unexposed counterparts” (Bills et al., 2008). In a 9-year longitudinal cohort study with data gathered from 27,449 participants, including a population of police officers and firefighters among other rescue workers; the cumulative results yielded a 9.3% incidence of PTSD, 8.4% panic disorder, and 7.0% depression, with the higher rates found among those with direct exposure (Wisnivesky et al., 2011). Besides risk factors that contribute to developing PTSD, underestimating its pathophysiological effects can exacerbate the condition. According to Boscarino and Adams (2009), even though 90% of adults have experienced at least a traumatic event in their life; only a small percentage develop PTSD. This further validates the concept of the influence of underlying risk factors post
The Trauma Symptom Inventory (TSI), originally published by the Psychological Assessment Resources, in 1995 and created by John Briere Ph. D., is utilized to evaluate acute and chronic posttraumatic symptomology. The materials associated with administering this test include the use of a computer with Windows XP, 7, 8, or 10, must maintain a NTFS file system, CD-ROM drive for installation, internet connection or a telephone in order to activate. One can download all of the other necessary materials from PariConnect, which include the introductory kit, necessary software, professional manuals, scoring sheets, among other reusable booklets. Prices range from $52.00 upwards to $375.00.
PTSD having been on the rise following various deployments necessitated by the various wars against terror, where the soldiers encounter traumatic experiences like harsh training conditions, unfavorable living standards, enemy attacks, extreme working environment, explosions, torture by enemies, loss of colleagues as well as long term separation from family back at home (Melinda S & Jeanne S., 2012). This therefore calls for a concerted effort in handling the pandemic of PTSD since it has been constantly on the increase and as a
The freedoms Americans enjoy come at a price; brave military men and women often foot the bill. Many men and women pay with their lives; others relive the sights, sounds, and terror of combat in the form of PTSD. Several causes and risk factors contribute to the development of PTSD. Combat-related PTSD appears slightly different than traditional PTSD. History tells of times when soldiers diagnosed with PTSD were viewed as “weak.” Resources have not always been available to struggling soldiers. The adverse symptoms of PTSD on soldiers and their families can be crippling.
Post-Traumatic Stress Disorder (PTSD) has been studied extensively. The majority of the population has experienced an event that was traumatic enough to potentially cause Post-Traumatic Stress Disorder with it also being common for most people to experience more than one event with the potential to induce Post-Traumatic Stress Disorder (Kilpatrick, Resnick, Milanak, Miller, Keyes, Friedman, 2013). Studies have shown that veterans diagnosed with Post-Traumatic Stress Disorder show an escalation in the anxiety levels that is much greater than soldiers that have not been diagnosed with PTSD as well as higher than the general fit population (Olatunji, Armstrong, Fan, & Zhao, 2014).
I find it troubling that our Soldier’s Post Traumatic Stress Disorder symptoms are being discredited by the medical community. It appears as though there has been a shift in our commitment to the health of the men and women who served this nation. These ideas connect to the overall ideas of the unit because it provides greater insight on challenges that patients and medical professionals experience when coping with cognitive health concerns. I do not have any personal experience associated with PTSD; however, the problem that I find in this article is that it suggests the effects of trauma which causes PTSD can be measured by a universal criteria. For example, I believe this research should consider that each individual has a unique level of tolerance to trauma which may cause them to respond in varying degrees of severity. Additionally, a patient’s inability to accurately express their symptoms may play a major factor which is causing this disparity. I recommend that further research should be conducted to
Although posttraumatic stress disorder (PTSD) is sometimes considered to be a relatively new diagnosis, as the name first appeared in 1980, the concept of the disorder has a very long history. That history has often been linked to the history of war, but the disorder has also been frequently described in civilian settings involving natural disasters, mass catastrophes, and serious accidental injuries. The diagnosis first appeared in the official nomenclature when Diagnostic and Statistical Manual of Mental Disorders (DSM)-I was published in 1952 under the name gross stress reaction. It was omitted, however, in the next edition in 1968, after a long
In the United States (US) posttraumatic stress disorder (PTSD) affects 8 out of every 100 persons (United States Department of Veterans Affairs [USDVA], 2015). In which account for about 8 million people that include the military veterans (USDVA, 2015). About 10% of women and 4% of men will develop PTSD during some course of their lives (USDVA, 2015). Veterans are more susceptible to PTSD due to longer exposures to trauma, danger, or witness a violent life threaten incidence during their military service periods (USDVA, 2015). The development of PTSD becomes chronic after no longer seeing or under the “fight-or-flight“ experiences causing a psychological and/ or mental breakdown (National Institutes of Health [NIH], n.d). Such
Much of the literature in this review points to provider training and awareness as a cornerstone to building trauma informed service delivery environments. Several studies found that development of TIC culture was only possible when staff were confident and competent in the knowledge of the prevalence and impact of trauma on patients, and the understanding of their responsibilities in mitigating retraumatization (Elliot et al. 2005; Gatz et al. 2007; National Center for Trauma-Informed Care 2011). However, training in TIC is not routinely incorporated in nursing or medical education, and clinicians vary in their comfort level with addressing trauma exposure in their patients. For example, Zatzick et al. (2005) found that 86% of emergency physicians incorrectly believed injury severity to be a risk factor for PTS symptoms. Other studies have found that many providers report discomfort discussing trauma and its health effects (Shulberg & Burns, 1988; Von Korff et al. 1988), in part because providers didn’t want to “open Pandora’s box” by addressing trauma when not adequately trained to respond to it. In addition to lacking confidence in their ability to address traumatic exposure, many providers may be triggered by own trauma histories (Moses, Huntington, & D’Ambrosio, 2004). More work is needed to identify the degree to which providers’ own trauma exposure may influence their ability to competently provide trauma informed care, and how compassion fatigue or secondary trauma
Post-traumatic stress disorder (PTSD) among veterans has been prevalent in the United States ever since the diagnosis of shell shock after World War I. PTSD continues to be prevalent in veterans from the Vietnam War, to the Gulf War, to Operation Enduring Freedom and Operation Iraqi Freedom. The estimated lifetime prevalence of PTSD among veterans during the Vietnam era was 30.9% for men and 26.9% for women (U.S. Department of Government Affairs, 2015). Based on a population study the prevalence of PTSD among previously deployed Operation Enduring Freedom and Operation Iraqi Freedom was 13.8% (U.S. Department of Government Affairs, 2015). PTSD in combat veterans can be very difficult to understand. This is widely due to the lack of research
The symptoms of Post Traumatic Stress Disorder vary. They can include an increased level of anxiety, which can result in difficulty sleeping, concentrating, and an exaggerated response to noise. PTSD can affect a woman who has experienced sexual assault ability to remember past events, in particular events associated with her assault. (2) PTSD can cause feelings of detachment and numbness, as well as a desire to avoid anything that the victim might associate with her assault. While doctors have been able to identify the symptoms in many victims of sexual assault the exact cause of the disorder is still questioned. Is the disorder the body's response to trauma? If so what relationship exists between the symptoms associated with PTSD as trauma? A strong correlation has been found between sufferers of PTSD and poor health. (3) PTSD can lead to depression and sickness. PTSD if not treated can also indirectly cause accidents that can affect a victim's health. These accidents can be the result high levels of anxiety, of a lack of ability to focus, and a lack of ability to respond.
As we grow older our susceptibility to a traumatic incident increases dramatically (Chan, Moran, Clarke, Martin, & Solomon, 2009). Elderly
he concepts of trauma and trauma-informed care have evolved greatly over the past 30 years. Following the Vietnam War, professional understanding of post-traumatic stress disorder (PTSD) increased. The greater understanding of trauma and its effects on war veterans has extended to informing our comprehension of trauma in the civilian world and with children and families who have experienced abuse, neglect, and other traumatic events. This elevated insight has led to the development of evidence-based models of trauma treatment along with changes in organizational policies and practices designed to facilitate resilience and recovery.