1. Brandy Porterfield
Shaping Sheet
10th Honors World Literature/Composition
Lester
11 April, 2012
Part I: Research Question 1
Q: Is PTSD a legitimate illness?
CD: Before the 1986 change of direction, The VA (Department of Veterans Affairs) and military
doctors commonly diagnosed veterans demonstrating symptoms of PTSD as having a
personality disorder, obsessive-compulsive disorder, paranoia, or schizophrenia, but never with
PTSD (“The Veteran’s PTSD Handbook).
Commentary:“What happens if this person served in WW1, WW2, the Korean War, Vietnam, or
during the 60’s, 70’s, or early 80’s and has PTSD? Because the VA did not recognize PTSD as an
illness prior to 1986, this individual would be separated from the military without medical
retirement benefits or assistance from the Department of Veterans Affairs” (The Veterans PTSD
Handbook).
Commentary: The general public has always been intolerant of mental illnesses and often looks
down on those displaying such an illness.
Commentary:A soldier devotes his lifeto his country and withstands extreme trauma on a day
to day basis when in physical battle. Persons who have experienced a trauma in which they
experienced, witnessed or were confronted with an event involving actual or threatened death,

2. serious physical injury, or a threat to one’s physical integrity typically develop a psychological
illness.
Commentary: This illness, referred to as PTSD in today’s time, deserved proper recognition and
diagnosis long before the 80’s.
Insert photo’s and QUOTE: “Victims are the members of society whose problems represent the
memory of suffering, rage and pain in a world that longs to forget.” –Bessel van der Kolk
CD: Clinician and researcher, Bessel van der Kolk, first discovered the reality of PTSD when he
decided to go work for the Veterans Administration (VA) in 1978. “At that time, tens of
thousands of men who’d served in Vietnam suddenly seemed to come out of the woodwork,
suffering from flashbacks, beating their wives, drinking and drugging to suppress their feelings,
closing down emotionally,” recalls van der Kolk (Wylie, The Limits of Talk).
Insert Photos of Vietnam war
Commentary: “It was a phenomenon that spawned a whole generation of researchers and
clinicians fascinated by what had happened to these guys.” –van der Kolk
Commentary: In the years since this phenomenon researchers have set off an explosion of
knowledge about psychobiology and the interaction of the body and mind.
Commentary: The trauma field has gone from oblivion to become one of the most advanced
and scientifically supported specialties in mental health.
Insert photos of researchers/ scientists
CD: The National Center for Post-traumatic Stress Disorder was created within the Department
of Veterans Affairs in 1989 in response to a congressional mandate to address the needs of
veterans with military-related PTSD (The Veterans PTSD Handbook).

3. Commentary: Its mission was, and remains: “to advance the clinical care and social welfare of
America’s veterans through research, education, and training in the science, diagnosis, and
treatment of PTSD and stress-related disorders.”
Commentary: PTSD is not a new disorder. Written accounts of similar symptoms can date back
to the Civil War when a PTSD-like disorder was known as “Da Costa’s Syndrome.”
Commentary: Although PTSD may have not always been considered a legitimate mental illness
through-out history, the disorder is now highly recognized and accounted for.
Part II: Research Question 2
Q: What treatments are most effective in treating PTSD?
The science of PTSD: PTSD has a biological basis. It is associated with a host of chemical changes
in the body’s hormonal system, immune system, and autonomic nervous system. Medical
research suggests that the intense bursts of brain activity during traumatic experiences may lay
down new neural pathways in the brain. (Invisible Wounds).
CD: In 2004 the VA and DoD jointly released a set of clinical guidelines for treating PTSD. The
guidelines included individual psychotherapy, group therapy, and pharmacotherapy.
Commentary: Individual psychotherapy consists of Exposure therapy, Cognitive restructuring,
Stress Inoculation Training, EDMR (Eye Movement Desensitization and Reprocessing)

4. Commentary: Group therapy consists of four to twelve clients, led by a mental health
professional, sharing thoughts and finding comfort in knowing they are not alone and gaining
confidence by helping others resolve their issue. Little research has been done to validate its
effectiveness or to delineate those characteristics of group therapy that lead to improved
clinical outcomes (Invisible Wounds).
Commentary: In terms of pharmacotherapy, evidence indicates that certain medications,
especially selective serotonin reuptake inhibitors (SSRI’s) such as Prozac and Zoloft, are
effective at relieving core symptoms of PTSD.
CD: Exposure therapy, also referred to as flooding, imaginal, in vivo, prolonged, or directed
exposure, is a type of treatment that requires the client to focus on and describe the details of
a traumatic experience in a therapeutic manner (Garske, Military Related PTSD).
Commentary: Prolonged Exposure has proven effective in the treatment of PTSD symptoms
associated with a variety of traumas, including combat. This type of exposure significantly
reduces symptoms such as general anxiety, depression, guilt and anger.
Commentary: Virtual Reality, a specific form of exposure therapy, can create environments
containing a wide range of trauma cues in a customized fashion, providing the clinician with a
potentially powerful tool to facilitate activation of the fear memory and modulate emotional
engagement. ‘A case illustration on an Army infantryman named Michael in his mid 30’s with
approximately 9 years of active duty service displayed the effectiveness of Virtual Reality
Exposure. Michael’s pretreatment score of 58 was above the frequently used cutoff of 50 for
screening positive for PTSD. After six sessions of VRE, the patient’s pretreatment PCL score of
58 was halved to 29, well below the frequently used cutoff for PTSD’(Reger, Gahm).
Commentary: EDMR instructs clients to imagine a painful traumatic memory and associated
negative perceptions (such as shame or guilt) while visually focusing on the rapid eye
movement of the therapist’s finger. Several randomized controlled trials have been published
over the last few years that suggest the EDMR is effective in reducing PTSD symptoms.

5. Insert therapy photos
Part III: Research question 3
Q: How do veterans with PTSD affect the community?
CD: For people with PTSD, memories may be triggered by sights, sounds, smells, or feelings
that remind them of the traumatic event. (Invisible Wounds).
Commentary: Many veterans suffering from PTSD struggle from the symptoms of reoccurrence.
Commentary: For example, the sound of a car engine may trigger the memory of shots fired on
the battle field therefor the veteran may become frightened or startled into reliving a traumatic
scene.
Commentary: Many of these reactions may cause one to become isolated.
CD: Veterans with PTSD perpetrate domestic violence at greater rates than comparable
veterans without PTSD (Invisible Wounds).
Commentary: Getting anxious and angry over little things, the veteran makes everyday life for
the family extremely stressful.
Commentary: Stressful event may lead the veteran to feel emotionally numb and “put up a
wall.”
Commentary: In other situations, the veteran with PTSD may have a sharp temper or violent
streak that scares or angers a spouse.

6. CD:Troubled veterans are spilling into the criminal justice system. A small fraction wind up in
prison for homicides or other major crimes but far more, though, are involved in drunken bar
fights, and alcohol fueled domestic violence. Their stories often spool out in raptured families,
lost jobs and crushing debt (Alvarez).
Commentary:Substance abuse is rising among veterans of combat in Afghanistan, Iraq. Studies
find that drinking is more prevalent in the military than in the civilian population; the behavioral
survey reported that heavy drinking among 18-25 year old men in the Army and the Marines
was almost twice as common among their civilian counterparts.
Commentary:Another major aspect concerns veterans trying to maintain jobs or even get back
into the work force after war. Dealing with the symptoms of PTSD, a veteran struggles to work
to their potential.