Higher in women, single, divorced, widowed, socially withdrawn, of low socioeconomic level.
No enough explanation of structural alterations of amygdala.Dependent on medications to cure patients. Medications are expensive and leave side effects
Journey to posttraumatic stress disorder
A JOURNEY TO POSTTRAUMATIC STRESS DISORDER Theoretical Approaches to mental health and illness Sajia Afrin
LEARNING OUTCOMES: What is PSTD? The leading factors and symptoms of PSTD. Association of different theoretical approaches with PSTD. Social perspective of PSTD.Conclusion.
HOW CAN WE IDENTIFY?Have you experienced flashback of any horror events make you morenervous, and increase fear in your mind?Have you seen any person with headlight car crash may reportheadlights coming towards him all the time?Have you ever felt troubling to remember all parts of any event? How do you feel about this? It is PSTD (Post-Traumatic Stress Disorder)
WHAT IS PSTD ?? It is an anxiety disorder. People often experience when they exposed to any traumaticevents and recall and reexperience the horrible momentsrepeatedly. (Yehuda, 2002)Development of PSTD associated with significant functionalimpairment. ( Skelton et al, 2011)
WHAT CAN LEAD TO DEVELOP PSTD? Any traumatic events…………………… • Vicious personal assaults Child sexual attack Sexual assault Physical abuse or attack • Terrorist attacks •Serious accidents. •Natural disasters. • Combat or Military exposure. • Massive loss and death in war.
WHO CAN BE SUSCEPTIBLE TO THIS DISEASE ? Everybody !!!!
HOW SEVERE IT IS?????? Lifetime prevalence is 8 % ( among general population). Risk of people who exposed with traumatic events are 75 %. Rates as high as 58% in heavy combat 1-14% non combat Torture ( 50-75%) Natural Disaster victims 4-16%Twice percent common in women than men The conditional risk for PSTD ranges from 5 to 31% (Kulka etal, 1990)
WHEN DOES IT DEVELOP ???? Person may develop PTSD after a week or month afterexperiencing traumatic events. It often develop adequately after 3 months of traumatic events. For some people it develops after 6 months. It continues with a longer period of time.
WHAT ARE THOSE SYMPTOMS???? Difficulty in concentration Problem in forget things and events. Re-experiencing traumatic events through flashback or nightmares. Avoiding people, places or reminding the past trauma. Feeling detached from others. Feeling angry and unable to trust people. Feeling numb, hopelessness and fearful . Disturbance in sleeping.
WHAT CAUSES TO THIS DISEASES?Genetic and PSTD:PSTD is heritable!!!!!!! People with first-degree relatives have twice more higher risk to develop PSTD. Monozygotic twins have 30% possibility to develop PSTD. (Lyons et al, 1993) Weakness of the genetic model: No specific gene found. No separation from environmental factors. PTSD cannot be assessed in those individuals who are not exposed to trauma. Result can’t be generalized.
NEUROBIOLOGY AND PSTDChanges in HPA Axis Vulnerability to PSTDI. Volume of the hippocampus is reduced.II. Functional changes in Amygdala.III. Decreased volume of frontal cortex.IV. Alterations in functions of neurotransmitters (GABA, Serotonin) (Christine et al, 2009) Weakness of the model No enough explanation of structural alterations of amygdala. Dependent on medications to cure patients. Medications are expensive and leave side effects.
Psychodynamic model and PSTD1. Cognitive- behavioral model and PSTD2. Humanistic-existential model and PSTD Strength of the model Deal with individual patients emotions and feelings. Allow patients for free association. Descriptive explanation available. Reflects a broader meaning of this disease.
Psychodynamic and PSTD cont…. Weakness of the model : Less scientific evidence. Too complex and hard to understand. Very subjective. Though psychodynamic model have some weakness in representing the PSTD disease, but is it one the best model that covers and explains the hidden attributes of the post- traumatic stress disorder.
SOCIAL PERSPECTIVES OF PSTD People who develop PSTD oftenface social withdrawal that increase the vulnerability more than preliminary stage.
TO SUM UP…Genetic model and PSTD : Heritability association of PSTD.Neurobiological model and PSTD: Brain functions dysfunction.Cognitive-behavior model and PSTD: Relationship of emotions andreactions.Humanistic-existential model and PSTD : Psychological interaction ofhuman with society and world. Psychodynamic model is best
REFERENCESAnanda B. Amstadter, Nicole R. Nugent, and Karestan C. Koenen,. "Genetics of PTSD: FearConditioning as a Model for Future." NIH Public Access. 2009: 39(6): 358–367.Anke Ehlers, David M. Clark. "A cognitive model of posttraumatic stress disorder." BehaviourResearch and Therapy. 1999: 27.Christine Heim, Charles B., Nemeroff. "Neurobiology of Posttrumatic Stress Disorder." CNS Spectr.2009: 12.Claes SJ. "Corticotropin-releasing hormone (CRH) in psychiatry: from stress to psychopathology”. AnnMed 2004: 36(1):50–61.Corbett L., Milton M. "Existential Therapy, A useful Approach to Trauma?" Family therapy. 2000: 31.Lyons MJ, Goldberg J, Eisen SA, True W, Tsuang MT, Meyer JM. “Do genes influence exposure totrauma? A twin study of combat. American Journal of Medical Genetics”. 1993: 48(1):22–27.Yehuda R. "Post-Traumatic Stress Disorder ." The New England Journal of Medicine. 2002:108-114:Vol. 346, No. 2. "Understanding Post-traumatic Stress Disorder." Post-traumatic Stress Disorder. 01 Nov. 2012.<http://www.mind.org.uk/help/diagnoses_and_conditions/post-traumatic_stress_disorder>.Skelton, K., et al., PTSD and gene variants: New pathways and new thinking, Neuropharmacology(2011),doi:10.1016/j.neuropharm.2011.02.013