After the attacks on the world trade centers the U.S. was forced to fight a war against international terrorism. To find and destroy suspected terrorist bases the U.S. invaded the country of Afghanistan to kill or capture Al Qaeda terrorists. In addition to invading the country of Afghanistan the U.S. also invaded the country of Iraq to find and destroy Weapons of Mass Destruction (WMD's). However, the sizes of these two engagements have not been seen since the war in Vietnam. Unlike previous conflicts the warfare being waged inn both conflicts is an unconventional guerilla style war in which enemy combatants are not affiliated with a specific country nor do they wear a identifiable uniform. These insurgents assume the identity of a civilian Rather than an enemy combatant and their main weapon of choice is the improvised explosive device (IED). The use of such a weapon allows the insurgents to remain unseen while inflicting a large number of casualties on U.S. troops.
Advances in modern body armor have come a long way since the old flak jackets of WWII. The body armor of today is lighter and more resistant to the concussive blast force explosives as well as resistant to modern ballistics. The body armor in many cases consists of ceramic plates that cover the front and back of the torso. In addition to the improvements found in the modern day flak jacket the helmet or Kevlar has also improved. Due to advances in technology the kevlars of today are also lighter and more resilient to modern ballistics as well as explosive blast forces. Although the new body armor has improved the survivability of what would have been fatal injuries there is a limitation to the new armor. For example, the new body armor does an excellent job of protecting the torso and but head it leaves the face and limbs vulnerable. As a result many service members are suffering traumatic brain injuries as well as the amputation of one or more limbs. There is now a growing concern about the long-term effects of suffering such injuries. In a self report study Hoge (2008) found a strong association between PTSD and soldiers who suffered a mild traumatic brain injury.
With the use of improvised explosive devices being the trade marks of both Afghanistan and Iraq along with a strong correlation between traumatic brain injuries and PTSD there is now a growing concern about the rising numbers of PTSD cases. IN Particular the Veterans Administration is concerned about its capability to effectively handle the increase in PTSD cases while still providing adequate care for the veterans it is already treating for PTSD. However, the Veterans Administration lacks the necessary information to determine its own capabilities. One reason for this lack of information is due to how treatment is provided to veterans with PTSD. For example, the Veterans Administration provides two types of programs that include specialized programs at medical facilities as well as non-specialized programs located at vet centers and general mental health clinics. In both cases a veteran has access to individual counseling, support groups, as well as drug and alcohol counseling. Consequently the information at the non-specialized vet centers and mental health clinics is held separately from the information at the medical facilities. Due to not having a centralized data base the VA does not know the exact number of veterans it is treating currently and therefore can not determine its own capabilities in dealing with the expected influx in PTSD cases.
PTSD is a complex stress disorder that can be caused by a variety of factors; Questions are being raised about the experience of combat and its correlation to PTSD in service members. Past studies have shown that deployment stressors and exposure to combat result in a considerable risk for mental health problems (Hoge et al. 2004). For example, some factors that seem to be taking an emotional/mental toll on U.S. troops is from the type of warfare they are facing in fighting an unseen enemy who frequently uses improvised explosive devices along with maintaining strict rules of engagement. It seems that these stressors along with experiencing violent combat appear to be more of a problem associated with troops fighting in Iraq. A study by Hoge (2004) showed that personnel who were deployed to Iraq reported a higher percentage of experiencing a traumatic event such as combat, witnessing a friend’s death, handling dead bodies, and killing enemy combatants; as a result more veterans returning from Iraq are reporting a higher percentage of PTSD. Another study that supports these claims was done by (Gallers et.al 1988) which found that the primary contributing factor o developing PTSD is exposure to traumatic violent combat.
In contrast to study violent combat on the development of PTSD a study done by Brailey et.al (2007) examined an individual's emotional functioning pre-deployment as well as post deployment; More specifically it involves how an individual's personal histories and situational factors prior to being deployed and how these factors can influence his or her emotional functioning post deployment. This particular study found that individuals who possess pre-deployment stress symptoms that may become activated by the additional stress caused by being deployed to a combat zone; according to Brailey et.al (2007) due to the potential of the pre-deployment stressors becoming active makes these individuals more susceptible to developing PTSD. However, Brailey et.al (2007) also found that a mitigating factor to an individual developing PTSD was by having high unit cohesion. This study also highlights the stress evaporation model which emphasizes the role of an individual's pre-military psychosocial factors in individual developing adverse combat psychological reactions such as PTSD. Conversely, the study done by Gallers et.al (1988) supports the residual stress model which is diametrically opposed to the stress evaporation model. This particular model views the development of PTSD as a result of an individual being exposed to a severe stressor such as combat.
The war on international terrorism will continue as long as there is a group of individuals who oppose the way of life in America. As long as these individuals pose a threat to the U.S. the men and women of our armed forces will defend our way of life until this threat no longer exists. However, as long as this particular war is being waged mental health disorders and in particular PTSD will remain an important issue. As the number of PTSD cases rise the Department of Defense along with the Veterans Administration are taking necessary steps in dealing with this growing problem. For example, the two governmental agencies have developed a seamless transition program that is aimed at improving the sharing of information between the two agencies. For example, the DOD uses two approaches which are the combat stress control program and the post-deployment health assessment in determining which individuals may be at risk for developing PTSD. Along with providing the VA with the results from such assessments the DOD has also provided the VA with demographic information in regards to the locations of where returning veterans are moving back to. Although the government has taken the initial steps of dealing with the growing number of PTSD cases additional research is needed in understanding PTSD. For example, identifying those individuals who are at risk of developing PTSD is only one side of the equation in dealing with PTSD; in addition to this understanding it would also be of equal importance to conduct research in the factors that allow a person to be resilient to developing PTSD. By being able to determine those individuals who are at risk as well as those who possess the necessary factors to be resilient helps to provide a more complete picture of the over all situation.
Post Traumatic Stress Disorder M7 A2
Post Traumatic Stress Disorder A Growing Concern Jason Murray [email_address] Argosy University
Abstract <ul><li>After the attacks of September 11, 2001, the U.S. found herself fighting </li></ul><ul><li>a war against international terrorism. After invading the countries of </li></ul><ul><li>Afghanistan and Iraq, the military encountered strong resistance from </li></ul><ul><li>enemy combatants in the form of an insurgency. The main tactic of </li></ul><ul><li>the insurgents in both conflicts was to conduct gorilla style warfare </li></ul><ul><li>with the main weapon of choice being the improvised explosive device </li></ul><ul><li>(IED.) This style of warfare allowed the insurgents to minimize the </li></ul><ul><li>overwhelming firepower that the U.S. military could bring to bear down </li></ul><ul><li>on a specific target while inflicting the maximum number of casualties. </li></ul><ul><li>Consequently, there is an increased number of service members </li></ul><ul><li>returning from Iraq and Afghanistan who have been diagnosed or are </li></ul><ul><li>believed to have developed PTSD. This increase in the rate of </li></ul><ul><li>individuals with PTSD is now causing concerns in the Veterans </li></ul><ul><li>Administration's (VA) ability to effectively treat these individuals while still </li></ul><ul><li>providing care for current patients with PTSD </li></ul>
Discussion <ul><li>Attacks on World Trade Center lead to war on terrorism </li></ul><ul><li>U.S. invaded Iraq to find and destroy weapons of mass destruction </li></ul><ul><li>Warfare being waged is unconventional guerilla style insurgency with use of Improvised Explosive Devices (IED’s) </li></ul>
Discussion Cont. <ul><li>Improved body armor improved survivability of IED attacks </li></ul><ul><li>Limitation of body armor leaving face and limbs vulnerable to force of blast explosives </li></ul><ul><li>Increased number of traumatic brain injuries and a strong association between Traumatic Brain Injuries (TBI's) and PTSD </li></ul>
Discussion Cont. <ul><li>Increased number of PTSD cases has VA concerned about it’s capability to deal with this increased case load effectively </li></ul><ul><li>VA treatment for PTSD </li></ul><ul><ul><li>Specialized PTSD programs individual counseling </li></ul></ul><ul><ul><li>Support groups </li></ul></ul><ul><ul><li>Drug/alcohol counseling </li></ul></ul><ul><ul><li>Non-specialized clinics/ general mental health clinics </li></ul></ul><ul><li>VA lacks necessary information to determine it’s own capabilities in dealing with the influx of new PTSD cases </li></ul>
Discussion Cont. <ul><li>Deployment stressors and exposure to combat result in a considerable risk for mental health problems (Hoge et al. 2004). </li></ul><ul><li>Veterans deployed to Iraq reported experiencing more traumatic events such as handling dead bodies, killing combatants, and witnessing a friends death </li></ul><ul><li>Exposure to traumatic violent combat has been found to be a primary contributing factor in developing PTSD </li></ul>
Discussion Cont. <ul><li>Pre-deployment stress-related symptoms may serve as vulnerabilities which could be activated by war time stressors. </li></ul><ul><li>Unit cohesion may help to mitigate these stress related vulnerabilities; high unit cohesion lowers the potential risk </li></ul><ul><li>Residual stress model of PTSD </li></ul><ul><li>Stress evaporation model of developing PTSD </li></ul>
Conclusion <ul><li>As the U.S. continues to wage war on international terrorism, mental health will remain an important issue </li></ul><ul><li>The Department of Defense along with the VA have developed seamless transition program to help deal with rising numbers of PTSD </li></ul><ul><li>Research needs to be conducted on the factors that allow a person to be resilient to PTSD </li></ul>
References <ul><li>Bascetta, C. A. (2004). VA and defense health care: more information needed to determine if VA can meet an increase in demand for post-traumatic stress disorder services (Report No. GAO-04-1069). Washington, D.C. </li></ul><ul><li>Brailey, K., Vasterling, J. J., Proctor, S. P., Constans, J. I., & Friedman, M. J. (2007). PTSD symptoms, life events, and unit cohesion in U.S. soldiers: baseline findings from the neurocognition deployment health study. Journal of Traumatic Stress, 20(4), 495 503. </li></ul><ul><li>Comer, R. J. (2005). Fundamentals of abnormal psychology. New York: Worth Publishers. </li></ul><ul><li>Gallers, J., Foy, D. W., Donahoe Jr, C. P., & Goldfarb, J. (1988). Post- traumatic stress disorder in Vietnam combat veterans: effects of traumatic violence exposure and military adjustment. Journal of Traumatic Stress, 1(2), 181-192. </li></ul>
References Cont. <ul><li>Hoge, C. W., Castro C. A., Messer S. C., McGurk D., Cotting D. I., & Koffman R. L.(2004). Combat Duty in Iraq and Afghanistan, mental health problems, and barriers to care. The New England Journal of Medicine, 351 (1), 13-22. Retrieved November 4, 2008, from http://content.nejm.org/cgi/content/full/351/1/13 </li></ul><ul><li>Hoge, C.W., McGurk, D., Thomas, J. L., Cox, A. L., Engel, C. C., & Castro, C. A. (2008). Mild traumatic brain injury in U.S. soldiers returning from Iraq. The NewEngland Journal of Medicine. 358 (5), 453-463. Retrieved November 4, 2008, from http://content.nejm.org/cgi/content/full/358/5/453 </li></ul><ul><li>Kaplan, R. M. & Saccuzzo, D. P. (2009). Psychological testing: principles, applications, and issues. California: Wadsworth. </li></ul><ul><li>Myers, D.G. (2005). Exploring Psychology. New York: Worth Publishers. </li></ul>
References Cont. <ul><li>Richman, H. & Freuch, B. C. (1997). Personality and PTSD II: personality assessment of PTSD diagnosed Vietnam veterans using the Cloninger Tridimensional Personality Questionnaire (TPQ). Depression and Anxiety, 6 (2), 70-77. </li></ul><ul><li>Swapna, V., Orengo, C. A., Maxwell, R., Kunik, M. E., Molinari, V. A., Vaterling, J. J., and Hale, D. D. (2001). Contribution of PTSD/POW history to behavioral disturbances in dementia. International Journal of Geriatric Psychiatry, 6 (4), 356-360. </li></ul>