POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES
POST TRAUMATIC STRESS DISORDER: EFFECT AND RESPONSES
Stephen N. Jackson
February 22, 2015
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES
Abstract
In this research paper I discuss the “Efforts and Responses” of Posttraumatic Stress
Disorder, (PTSD) I will concentrate on related difficulties as well as recommended treatment
options. Also with in this research paper, I will incorporate spirituality biblical worldview
throughout this paper. Information will be taken from scholarly publications that is not eight
year old, books journey articles, and publication from secular and spiritual perspectives. No one
person is exempt from PTSD regardless of age, color, creed or nationality.
PTSD was first diagnosed with war time veterans and now survivors of sexual assault,
abuse, accidents, disasters and other serious events occurred which may occur in a person’s life.
Not to say just because you have been through a dangerous event, you will suffer with PTSD, but
it when a person is threaten or encounter unexpected major losses and other very upsetting
events which may include physical harm. “We all want a reason for what happens to us, but
sometimes we must live our lives with unanswered questions.” (Wright, 2011, p. 205) The New
King James says, “If I cry out concerning wrong, I am not heard. If I cry aloud, there is no
justice.” (Job 19:7)
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
Introduction
When we investigate people, who experience traumatic events in life we need to
understand the term “trauma” to get a better understanding. The word trauma means many
things to many people. Its denotation has been stretched beyond reasonable limits, with the
result that it has passed into ordinary parlance to describe an unpleasant surprise or a starling
experience. Trauma can also be emotional, striking at the core of a person’s identity and sense of
self. (Floyd 2006) The Diagnostic and Statistical Manual of the American Psychiatric
Association (DSM-IV, 1994), defines “Post-traumatic Stress Disorder” as characteristic
symptoms following exposure to an extreme traumatic stressor.”(Evenstine 2006, p 153)
In reviewing the manual, it is more specific with listing causal factors that leads to trauma
events. Some are direct personal experience that involves actual or threatened death and or
serious injury, and other threat to one’s personal integrity; person’s that witness an event that
may involve death, injury, a threat to the physical integrity of another person; and a person
learning about unexpected or violet death, serious harm, or threat of death or injury experience
by a family member or other close associate.
Additional factor we will investigate is three types of PTSD; Acute PTSD, Chronic PTSD
and Delayed Onset PTSD and it symptoms. It has also been noted that an anxiety disorder falls l
into the category of PTSD. This person tirelessly suffer from frightening thoughts, always
feeling unsafe, life-threatening thoughts as well as memories and flashbacks of events which
occurred. They tend to avoid other people, things and places that remind them of the trauma
event. Effect of PTSD, may be a delayed; not happening right away. This delay may take up to
six months or even longer if PTSD does not improve after three months, if its symptoms are
immediately.
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
PTSD, not long ago has been recognized and official diagnosis, whereas it was not
always called PTSD. It was first said the American Civil War solder’s suffered with “solder’s
heart. Later on another name was assume and carried the exactly the same symptoms but was
call “comdafatigue.” During World War II, another name was adopted, gross stress reaction, but
still the diagnostic was not correct. During the Vietnam War some were considered as having
“post-Vietnam syndrome, or “battle fatigue” and even “shell shock.” Through a quick
investigation along with its history, this paper will focus on “PTSD: Effects and Responses,” and
the difference types of treatments. Norman in the Complete Guide to Crisis & Trauma
Counseling (2011) says, “When you experience trauma, you’re thrown about like a rodeo steer.
Your world turns wild, out of control, crazy.” (p. 189)
Method
It has been noted that PTSD arises after someone experience a traumatic event and this
event can range from sexual abuse, car crash war time and even natural disaster. In dealing with
PTSD, it is a complex situation which the person normally cannot deal with by themselves.
Research shows that recovery is much possible when therapy techniques are incorporated that
includes a support system. Regardless what type of therapy, the effectiveness will depend upon
setting goals. Research shows that when a person go through trauma, the person losses all faith
that they are safe. PTSD is created by exposure to a psychologically distressing event that is
outside the scope of usual human understanding. This experience is a markedly distressing to
anyone and which cause intense fear, hopelessness and even fear to the person.
Research taken from Marinić, I., Supek, F., Kovačić, Z., Rukavina, L., Jendričko, T., &
Kozarić-Kovačić, D. (2007). Posttraumatic Stress Disorder: Diagnostic Data Analysis by Data
Mining Methodology using the Clinician-administered PTSD scale “includes 102 inpatients,
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
with 51 person’s diagnosis of PTSD and another 51 with psychiatric diagnoses other than PTSD.
(2007) As we research further, we see that there were a “number of models for predicting
diagnosis were built using the random forest classifier, one of the intelligent data analysis
methods.” (2007) “The first prediction model was based on a structure psychiatric interview, and
the second was on psychiatric scales.” (2007) (Clinician-administered PTSD Scale-CAPS,
Positive and Negative Syndrome Scale-PANSS, Hamilton Anxiety Scale-HAMA, and Hamilton
Depression Scale-HAMD) The third on combined data from both sources. “Another model
placing more weight on one of the classes PTSD or non –PTSD were trained and protypes
representing subgroups in the classes constructed.” (2007)
Effects of Trauma
Those who have worked with trauma victims in the immediate aftermath of a
traumatic event are well aware of how extreme ordeal may affect a person. The impact of
traumatic events is felt by survivors in all their functions, cognitive, behavioral, emotional,
spiritual and relational. Right after a traumatic event, a person’s body and mind appear to
function in a manner that serves to protect him or her, buffering the person from the full brunt of
the trauma event
In the article “Understanding the Effects of Trauma: Post-traumatic Stress Disorder,”
(2010) Margolies says, “The trauma is an assault to the person’s biology and psyche.” The
person began to suffer with three types of symptoms and effects from PTSD. “Hyperarousal” is
the first symptoms “Hyperarousal is when the “traumatized person’s physiology is in high gear,
having been assaulted by the psychological impact of the event that took place and they are not
able to rest.” (2010) “They would have difficulty sleeping and even concentrating; easily
startled, panic, agitation, anger, irritability and hypervigilance.” (2010)
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
The next symptom is “Re-experience.” “Re-experience is when the person has
nightmares, flashbacks of the event that occurred, exaggerated reactions to reminders of the
event, intrusive memories and re-experience. The last is “Avoidance or Numbing.” “Numbing is
described as the person feeling robotic or even on automatic pilot. He/she feels as if there are
disconnected from feelings and from vitality which is replaced by a sense of deadness.” (2010)
There are symptoms that goes along with the numbing/avoidance which are the “loss of interest
in life as well as other people, the feeling of hopelessness and isolation, avoidance of thoughts
and feelings associated with the traumatic event, feeling detached and estranged from others,
withdrawal, depression and emotional anesthesia.” (2010)
Responses
In many cases, a traumatized person will have been going about his or her daily life when
the event occurred in a totally unexpected way. Immediately on the impact of a traumatic event,
most people enter a state of “shock” that will serve to insulate them from the experience to some
extent. Shock is the first on the Trauma Response and Recovery Cycle. This state with its
characteristically dull affect is often mistaken for a survivor’s not being upset about what just
happen or as being “all right.”
Shock can last from a few hours to several days, or longer, depending on the severity of
the trauma that has been suffered and how long the person remained in the trauma situation. All
cognitive function is concentrated on one issue which is survival. In this state, the person sole
focus is surviving or getting through the event. Most victims will be suspended in this cognitive
survival state until the ordeal of the traumatic event come to an end. Then there is a stage of
denial or disbelief. After the traumatic event ends, the victim will be overcome by disbelief, the
mind reeling in a desperate attempt to cope with the situation. The sensation of disbelief occurs
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
because the mind, in a primitive way tries to dispel the confusion by pretending that the event
was not real. But when cold reality descends on the victim, there often occurs a stage during
which the person’s affect becomes quite frozen or flat. After this stage many people enter a
depressed or subdued stage, chiefly because very few are capable of expressed anger just after
being traumatized.
Toward the end of this depressed phase, a survivor usually experience mood swings.
Moreover, during these early stages, the person may feel considerable anxiety about his or her
mental stability and whether he or she will ever be normal again. He or she may be experiencing
flashbacks, through the feelings that likes of which he or she never dreamed possible.
Throughout this period , the clinician needs to reassure the survivor that what is happening is
part of a normal process, which will pass more quickly if he or she tries not to resist it, but
accepts it as normal. At this stage, it is found psycheducational written information to be very
helpful.
Treatment Options
Treatment for people that have PTSD may be treated with psychotherapy, medications, or
a combination of the two. Psychotherapy which is known as Cognitive therapy (CBT). CBT
teaches the person different ways of thinking and react to frightening events that may trigger
symptoms of PTSD. This method will help the person bring those symptoms under control.
Other types of CBT are: “Exposure therapy, which uses mental imagery, visiting and writing the
scene of the trauma in order to help the survivors face and to gain control of overwhelming fear
and distress situations.” (2012) “The Cognitive Restructuring method encourages the survivors
to talk about thoughts that are upsetting from the trauma event.” (2012) This includes
questioning those thoughts and then replacing them with more correct ones. “Stress Inoculation
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
training is another method, but this one teaches anxiety reduction techniques as well as coping
skills to reduce the symptoms of PTSD and to help correct inaccurate thoughts that is related to
the trauma.
While looking at Eye movement desensitization and reprocessing (EMDR) it focus on
hand movements or tapping while you are talking about the traumatic event. EMDR concentrate
on four main parts. The first is Desensitization and reprocessing, which the focal point is on
mental images, while doing eye movements that the therapist has taught the person. Second is
Installing positive thoughts and images, once the negative are no longer distressing, and lastly, is
called the body scan. The body scan focused on tension and or unusual sensations in the body
which will identify additional issues you need to address in a later session
The National Institute of Mental Health presented studies on how the brain responds to
CBT compared to medication sertraline or Zoloft. It is said, “One of the two medications
recommended and it is approved by the U.S. Food and Drug Administration for treatment of
PTSD.” (2010) this research also helps to clarify why some people respond well to medication
and others to psychotherapy. Additional treatment options for PTSD are medications. NIMH
research recently found that “for people already taking a bedtime dose of the medication prazosin
or minipress, if adding a daytime dose will help to reduce PTSD symptom severity as well as
stressful responses to trauma reminders.” (2010)
Research has shown other medication of interest which is D-cycloserine. “This
medication increases the activity of the brain chemical called NMDA which is needed for fear
extinction.” (2010) Another research study taken from NMDA, shows 28 people with a fear of
height, found that the treatment with D-cycoserine before exposure therapy showed a reduction
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
of fear while going through the therapy sessions which was compared to those who were not
given the drug.
Results
Igor Marinić (2007) results shows that the “first model used was the most applicable for
distinguishing PTSD diagnosis from comorbid diagnoses such as neurotic, stress-related as well
as somatoform disorder.” (2007) “The next model pointed out the scores obtained on the CAPS
scale and additional PANSS scales, together with comorbid diagnoses of neurotic, stress-related
somatoform disorder as most relevant.” (2007)
But in the third model, psychiatric scales and the same group of comorbid diagnoses were
found to be most relevant as well. The specialized models placing more weight on either the
PTSD or non PTSD class were able to better predict their targeted diagnoses at some expense of
overall accuracy. Class subgroup prototypes mainly differed in values achieved on psychiatric
scales and frequency of comorbod diagnoses.
Discussion
As we look at the study and research of PTSD, we find that it is a very common as well
as potentially disabling condition among children and adults. It is noted that up to about 50% of
children may or have developed PTSD following a traumatic event that occurred. The great
news is that many individuals recover without specific intervention. On the other hand, a large
number of children and adults or about 30% of victim’s disaster, go on to develop a chronic
disorder. We also find trauma focused psychological interventions which are successful for
treating PTSD in adults as well as youth. There is only a limited base which exits for children
and young adults. A great number of evidence is taken from work with children who may have
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
experience sexual abuse during childhood, as well as developing PTSD and consequently, the
evidence base for interventions for PTSD arising from traumas is weaker.
PTSD is increasing and recognizable to be frequent and halting disorder in adult, children
and adolescents, in developed and the developing society. We still have not uncovered all we
need to know about this widespread disorder called PTSD. As we research further, we have
uncovered that for many trauma survivors, the resource may be a spirituality which can be
associated with resilience and healing. In the book of Romans, it says, “But we also rejoice in
our sufferings, because we know that suffering produces perseverance; perseverance, character;
and character, hope.” (Romans 5:3-4 NKJV)
But on the other hand, for some situation of the trauma may lead to the questioning of
important and previously supporting beliefs. This may pilot to a spiritual struggle or loss of
faith. It is nothing wrong with the clinical professionals to feel comfortable in asking about how
spirituality has been affected by trauma and to what role does spirituality plays throughout their
recovery process after the trauma. The goal is to assist the person in their journey and to
encourage them in their faith. Overcoming trauma is a process, a journey and a road with many
arms. No one travels the journey alone; the Lord is with all of us. “The spirit of the Lord God is
upon us, because the Lord has anointed me to preach good new to the poor. He has sent me to
bind up the brokenhearted, to proclaim liberty to the captive and open the prison the those that
are bound.” (Isaiah 61:1)
Conclusion
This paper has attempted to demonstrate the applicability of data mining methods for the
analysis of structured psychiatric data for PTSD. “In all models, Igor Marinić points out that
the group of comorbid diagnoses, including neurotic, stress-related, and somatoform disorders,
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
surfaced as important.” (2007) One of the most important attributes of the data, “based on the
structured psychiatric interview, were the current symptoms and conditions such as presence and
degree of disability, hospitalizations, and duration of military service during the war, while
CAPS total scores, symptoms of increased arousal, and PANSS additional criteria scores were
indicated as relevant from the psychiatric symptom scales.” (2007)
It is good to know that there are exist effective trauma focused psychological treatment
for people with PTSD and promising trauma focused psychological treatment for acute PTSD.
But at this time there are no existing treatment is ideal and there is clearly a great need to
develop a more effective and tolerable treatment for PTSD. The outcome of early interventions
directed at everybody has very disappointing and should support anybody involved in providing
a response following a traumatic event to exercise intense caution before providing an official
intervention. Simple, practical, pragmatic support provided in a sympathetic manner by non-
mental health professions seems most likely to be the best first-line response but needs a better
evolution.
POST TRAUMATIC STRESS DISORDER: EFFORTS AND RESPONSES 1
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