Category: Stress

Research Problem

The research problem identified by the investigator relates to the prevalence of distress in the police occupation. According to the researcher, the definition of stress significantly applies to the police situation (Violanti, 1983). Stress develops from the perceived imbalance between the social environment and an individual, where failure to meet demands results in severe consequences. Faced with stringent legal regulations and patrolling demands, the police can undoubtedly perceive work as out of control. Moreover, the probability of failure in a police task is high because many crimes remain unsolved, and court cases are dismissed. Therefore, the police working conditions seem to fit the article’s definition of stress: many job demands, a low response capability, and the possibility of failing. The research problem is clearly stated as it provides a comprehensive overview of the issue and acknowledges other researchers’ perspectives.

The study was conducted because police officers are highly affected by stress-related sicknesses, including diabetes, heart disease, and suicide attempts. The police were ranked highest in heart disease among professional occupations, including lawyers, physicians, and professors. In addition, the rates of suicide in the line of work were twice as high, and it outnumbered officer homicides (Violanti, 1983). The author states that approximately 1500 police officers in New York City needed psychiatric help for stress complications within one year. Lastly, compensation claims in the occupation were found to be six times higher than other jobs, with thirty percent claims related to psychological problems and fifty percent linked to high blood pressure. Therefore, police work is among the most stressful occupations; therefore, it is critical to study this trend to ensure police work is done effectively without affecting the officers or citizens they handle. The purpose of this research is to examine the stress levels at various stages throughout a police officer’s career. There is no theoretical basis for this study. The research questions developed for this research are: is there a possibility that police officers’ perceptions on stress change after sustained exposure to the job, and is stress related to police work constant?

Measurement

The primary variable of the study was the mean stress measure, which was derived from the Langner-22 list of withdrawal and physiological items. The items were answered in terms of a scale of five points ranging between ‘strongly agree’ and ‘strongly disagree’. For every respondent, the stress measure was the sum of these 22 items. The score of officers involved in the study fluctuated between 22 and 110. The independent variable used was the length of police service, which was divided into four stages depending on the number of years an officer has been working (Violanti, 1983). The stages are alarm (0-5 years), disenchantment (6-13 years), personalization (14-20 years), and introspection (over 20 years). The independent variable is adequate because it has been operationally defined. The authors provided a precise elucidation of the variable mentioned above and how it is measured, which involves the criteria used to group police officers into these stages. By doing this, the investigator will ensure that the experiment does exactly what it needs to manipulate or do to obtain the expected changes on the dependent variable. An operational definition of the independent variable allows the researcher to measure it and establish if it is the one affecting changes on the other variable.

The dependent variable employed was the mean stress score for each respondent. The conceptualization is adequate because it is uniform and stable. If a similar experiment is conducted using the same conditions, experimental manipulations, and respondents, the outcomes on the dependent variable are likely to be very close or equal to what was obtained in this experiment. The measures used by the investigator were valid because the Langner-22 item test employed is simple and extensively used in stress studies (Violanti, 1983). Although controversies over the implementation of Langner’s scale exist, the method is predicted to be a valid psychological stress measure. However, due to a conceptual confounding of the dependent and independent variables, the measure is not reliable as it is an incomplete measure of mental issues, including stress-related problems.

Research Design

A research design is the selected, overall strategy that integrates the different study components in a logical and coherent way to ensure the research problem is addressed effectively. Violanti (1983) collected data from respondent officers through the Langner-22 item test, which gave the mean stress score of each individual. The figures were compared with the duration of police service, and a line graph was drawn to illustrate how the mean stress score changes at every stage of service (Violanti, 1983). The curvilinear relationship between career stages and stress was tested using polynomial regression. The method adds successive powers of the length of service to the regression equation to account for data’s curvilinearity. The regression equation used in the present study is stress = A + B₁ (police service length) + B₂ (police service length)².

Every independent variable power added symbolizes a bend in the regression line. Since the graph shows one bend, it means that only one power was added. During the initial stages before the bend, the mean stress score increased significantly as police service length increased. However, in the stages after the bend in the line, there was a significant decrease in stress as police service duration increased (Violanti, 1983). Threats to this research design’s internal and external validity include the omitted variable bias, possible measurement errors, misspecification of the regression functions, simultaneous causality bias, and missing the sample selection and data. The omitted variable bias occurs when the independent variable is measured imprecisely, and the error does not disappear even in large sample sizes. The aforementioned sources may cause the polynomial regression model estimator to be inconsistent and biased for the independent variable’s causal effect on the dependent variable. Therefore, the analysis of curvilinearity via polynomial regression should be restricted to experimental research.

Sampling

The target population in this study was police officers from Western New York police organizations. The sampling frame included full-time officers from twenty-one departments in the state. The frame from which the study’s sample was derived is appropriate as it included all officers in the target population. In addition, it constituted respondents who were currently in service and were available during the data collection process. A simple random sampling technique was used to randomly select five hundred full-time officers from the population to take part in the Langner-22 item test (Violanti, 1983). Since the size of police stations varied, smaller organizations were oversampled compared to larger ones. The technique was used because it is straightforward and common in quantitative research. One benefit of the aforementioned approach is that every instance of the population is given an equal opportunity to be chosen. Therefore, this guarantees that the selected sample is an appropriate representative of the sampling frame and that the selection happens in an unbiased manner.

To randomly choose the sample, the random number design was used to assign each police officer in the population a number. By using a random number table, a subset of integers was picked from the entire table, and police officers who correspond to the assigned numbers became part of the population (Violanti, 1983). Most random number tables have about 10,000 random numbers, which are composed of whole numbers between zero and nine. The random selection process continues until the desired sample size is achieved. An advantage of using random tables is that all integers have an equal chance of being selected and, therefore, its use is an efficient way of obtaining a random sample necessary for valid study outcomes. When used on large sample sizes, the sampling technique has high external validity as it represents the larger population’s characteristics.

Data Collection

The data collection method used in this study is the Langner-22 item test. The technique measures psychological strain in individuals and is theorized as a variable that intervenes between recent lifestyle changes and adverse health transformation. In this study, the test was composed of twenty-two withdrawal and psycho-physiological items, which were used as a stress measure. Some of the things included in the approach are feeling weak much of the time, being in high spirits, and the sense of being apart even in the company of friends. The aforementioned concepts were answered ranging from ‘strongly disagree’ and ‘strongly agree’ responses (Violanti, 1983). Every reply would be awarded points between one and five, respectively, and the sum of these points was employed as the stress measure. In addition, each officer indicated the number of years they have served full-time in the job, and this allowed appropriate placement into the right career stage. Subsequently, the results were discussed in light of the comparison between the stages or length of police service and the mean stress score.

One advantage of using Langner’s scale is that it is simple and extensively used in research related to stress. The test is a pioneering epidemiological tool that is widely implemented in detecting field cases related to mental issues. Secondly, the scale items are close-ended questions that seek to address self-reported psycho-physiological, psychological, and physiological complaints (Violanti, 1983). Therefore, this means that it is appropriate for measuring mental illnesses, such as stress disorders. Moreover, the items were selected based on their ability to isolate ‘known well’ and ‘known ill’ groups. However, the technique does not detect some psychological problems, including mental retardation, organic brain damage, and dimensions of anxiety, depression, anger, delusion, concentration difficulty, suspicion, and memory loss. Another disadvantage is that the scale cannot be used for diagnostic purposes because it does not determine the type of mental illness affecting an individual.

Results

According to the results, there was a curvilinear relationship between the mean stress score and the stages (length) of police service. The findings also show that the level of stress changes through the various officer career stages. Stress tends to increase in police officers in the alarm stage because the mean stress score increased to 53.31 from 40.35 during the initial five service years. Although stress levels will remain high from the first stage, police officers in the disenchantment stage do not experience increased stress. In the personalization stage, stress begins to reduce as the stress scores decreased from 58.12 to 45.6 from fourteen years to twenty years, respectively (Violanti, 1983). Finally, stress continues to decrease in the introspection stage. The stress scores lowered to 40.50 in police officers who are thirty-six years old. However, there was some stress increase before twenty-five years. The author noted that the increased tension might be due to anxiety about the expected retirement, but stress tends to decrease after this age.

The above results prove the study’s hypotheses, and, therefore, they fit with the original objectives. The first research question was to determine the possibility that police officers’ stress perceptions change due to continued exposure to the job. According to the research, police officers manage to reduce work stress on time despite the strong imbalances and pressures that arise from stressful working conditions. Therefore, this shows that they adapt and cast off the severities of work burdens. The second objective was to investigate whether stress is constant throughout the length of police service (Violanti, 1983). The researcher established that stress is not a continuous element in police service as it varies based on the perception that officers have of their work at different career stages. There was a significant increase in stress during the initial thirteen years of their career, which decreases substantially with increased service time.

Implications of the Findings

The investigator’s first conclusion is that stress is not consistent in police work as it depends on officer perception at different career stages. The aforementioned findings are linked to the complex association between work roles and individuals; workplace responsibilities offer people the best way of achieving intricate life goals, but they must pay the membership price, which involves the restriction of will, psychological well-being, or control. Violanti (1983) explains the importance of the above findings using three reasons. First, they explained how stress affects police officers throughout the course of their careers. By doing this, the researcher filled a research gap because this had not been previously investigated.

Secondly, the study demonstrated that individual officers are not entirely at the mercy of job pressures that stress them. Officers can manage to reduce stress in their lives despite the imbalances and strong pressures that arise from stressful work environments. Subsequently, this demonstrates that an individual police officer can perceptually adapt to the challenges that come with the police function and eliminate job pressure rigors. Based on this idea, Violanti (1983) reinforced individual perception’s efficacy in identifying stress levels. Lastly, the research findings can be used in isolating problem years in police departments. A significant outcome of the investigation showed that there is a substantial stress increase in the initial two stages of service (0-13 years). Managers can, for instance, concentrate stress reduction programs on officers in these particular phases. Moreover, new officers can be oriented on the possible stress periods in their future years of service. The author also concluded that police work stress seems to go through a predictable course, which highly depends on the perception of the workplace surrounding and experience.

With regards to discussing avenues for further research, the author stated that police departments could focus stress reduction programs on employees in the first two stages of their career. Future research can concentrate on developing evidence-based stress reduction approaches among police officers with less than thirteen years in the work. Subsequent research can also center on training police officers on, for example, perception modification or career adaptation early enough to reduce stress levels as they advance their jobs. Since the course of stress in police work had not been investigated in the past, this study opens an untapped area of research that could be advanced by other professionals in the field.

An area that should be expanded on the topic of police work and stress is police stressors. Investigation on the most significant sources of police stress will allow police departments and administrators to determine the frequency of these stressors and how they affect their health. Consequently, strategies to lower the exposure of police officers to these stressors can be established. The shortcoming of this study is that the author did not establish whether the elected sample is an appropriate representation of the entire police force in America. The data was collected from 21 police departments in Western New York State only. Violanti (1983) did not conduct a power analysis on the chosen sample, and this makes it impossible to ascertain the sufficiency of the sample in minimizing type 2 errors. Another limitation is that the researcher did not provide a comprehensive overview of the study’s limitations and strengths. The study did not have any spurious issues because the dependent and independent variables are associated and causally related.

Reference

Violanti, J. (1983). Stress patterns in police work: A longitudinal study. Journal of Police Science and Administration, 11(2), 211–216.

Introduction

Analysis of variance (ANOVA) is an inferential statistic employed in assessing if there is a marked difference between multiple means. In this scenario, one-ANOVA was applied to evaluate whether means of stress levels are different among individuals in three groups of no exercise, moderate exercise, and strenuous exercise. This type of ANOVA applies when an independent variable has more than two categories and a dependent variable exists on a continuous scale (Tanner, 2016). Physical activity has three categories showing the degree of exercise, while the level of stress has a numeric scale. A comparison of the differences in means would indicate if the degree of physical activity has a marked effect on stress levels. Therefore, the focus of this exercise is to interpret ANOVA results of the influence of physical activity on stress levels in individuals.

Research Question

The following research question was formulated based on information presented in the scenario of ANOVA analysis.

Question: Does the degree of physical activity determine the level of stress among individuals?

Hypothesis

The null hypothesis under study is that physical activity does not have a statistically significant effect on the level of stress among individuals. The alternative hypothesis is a non-directional test because the absence of means does not allow the determination of the directional effect of physical activity. While a hypothesis without direction tests whether a mean is greater than or less than a test value, a non-directional one focuses on the magnitude of differences (Tanner, 2016). The provided data lacks background information to indicate whether physical activity increases or decreases the level of stress in individuals.

Variables

The independent variable of this research is the degree of physical activity, while the independent variable is the level of stress. The study assumes that physical activity has a measurable influence on the level of stress. The type of inferential statistic employed in the analysis of data is one-way ANOVA. According to Tanner (2016), one-way ANOVA applies in the comparison of means between more than two groups. The scenario displays that the study compared three groups of individuals with varying degrees of physical activity. The study does not qualify to be a repeated-measures ANOVA because the post-test scores only were used in the analysis. In essence, the pre-test data formed the baseline scores used to control individual variations in the levels of stress at the time of measurement.

Sample Size

As indicated by the total degrees of freedom, the sample size is 30 (N-1 = 29). From the ANOVA table, the number of groups is 3 (k-1 = 2). Degrees of freedom of within-subjects (N – k) and total (N -1) indicate the sample size, while those of between subjects (k-1) show the number of treatments (Tanner, 2016). These three groups are individuals who received different interventions, namely, no exercise (control group), moderate exercise, and strenuous exercise.

Assumptions and Limitations

Data used in one-way ANOVA has to meet several assumptions to generate robust and valid findings. The independent variable should exist on a continuous scale to allow the determination of group means and variations (Blanca, Alarcón, Arnau, Bono, & Bendayan, 2017). The level of stress meets the assumption of interval scale as shown by the sum of squares (SS) and the mean sum of squares (MS). In contrast, the independent variable should be on a categorical scale with more than two independent groups (Blanca et al., 2017). The independent variable has three categorical groups, which measure the degree of physical activity into no activity, moderate activity, and strenuous activity. The participants of the study should exhibit independence of observations during the experiment (Blanca et al., 2017). In this case, the participants were in three independent groups without interacting in the course of the study. As other key assumptions, the independent variable should not have significant outliers, follow the normal distribution, and exhibit homogeneity of variance to avert skewed distributions and distorted variations.

The limitations of the analysis are lack of background information to allow interpretation of data. Descriptive statistics such as means are necessary to permit a directional test of hypothesis, and demographic information is required to extrapolate findings.

Interpret Results

Outcomes of one-way ANOVA fail to reject the null hypothesis that physical activity does not have a statistically significant effect on the level of stress among individuals, F(2, 27) = 0.766, p > 0.05. When the p-value is greater than the significance level, an inferential test fails to rejects the null hypothesis (Tanner, 2016). These outcomes suggest that individuals who performed strenuous exercise, moderate exercise, and no exercise had insignificant differences in means of the stress levels. Therefore, the examination of results answers the research question that the degree of physical activity does not determine the level of stress among individuals.

Conclusion

The level of stress among individuals depends on the influence of physical, social, and psychological factors. This scenario sought to demonstrate the effect of physical activity on stress levels among individuals. As the dependent and independent variables met the assumptions of one-way ANOVA, outcomes of analysis provided valid information. Based on p-value, results indicated that physical activity has no statistically significant influence on means of the stress levels.

References

Blanca, M. J., Alarcón, R., Arnau, J., Bono, R., & Bendayan, R. (2017). Non-normal data: Is ANOVA still a valid option?Psicothema, 29(4), 552-557. Web.

Tanner, D. (2016). Statistics for the behavioral & social sciences (2nd ed.). San Diego, CA: Bridgepoint Education

What do you do to sustain your inner, spiritual life to avoid burnout from stress?

Our everyday life creates numerous challenges to overcome and become stronger. However, very often, it becomes very difficult to cope with problems, anxiety, and stress in a short period. To improve the situation, the ideas about spiritual life, the possibility of “having a relationship with God…” that is “down deep in us, at the heart of things” (Vonderen, Ryan D, & Ryan J, 2008) become rather helpful. To sustain my inner spiritual life and avoid burnout from stress, I use my possibility to communicate with God any time I need. I know that He is not able to answer all my questions at once, but still, his hints fruiting the whole day impress me and encourage taking one more step. Sometimes, I turn on a CD with spiritual music or teachings about God that make me forget about the current affairs and all those problems around.

What spiritual exercises or rituals do you regularly include in your daily schedule?

My daily schedule is not rich enough because I am always so pressed for time. However, I never forget to thank God for one more chance to enjoy this life and spend one more day healthy. One more thing that makes my day complete is a smile. I never stop smiling at people around. All I want to do is to be kind to people and believe that these people will be also kind to me. Though our world is not perfect, spiritual hope is one more chance to improve something in our life. On weekends, I prefer to visit a church and think about my actions, thoughts, and relations with people. I get a good chance to evaluate all my life and discover how to improve it. Truth and forgiveness are somewhere high above, and a church helps mortals achieve these peaks from time to time.

What other resources or traditions have been helpful to you? Do the strategies offered by Patricia Brown and Roberta Fish on the video seem helpful?

There are many traditions, which become helpful to improve my spiritual life, and one of such traditions is reading. I find it rather effective to learn something new about spirituality from books. Reading a holy book needs to be the usual tradition of any person. The ideas of Patricia Brown and Roberta Fish seem rather helpful as well. The ideas of these people show that our life is full of innovations and challenges, which aim to check people’s attitudes to different things. If there is a chance to arrange a meeting and gather people to discuss the ideas of spiritual life and people’s place in this world, this chance should be used. I also believe that everyone should treat people around just the same way he/she wants to be treated. Everything has its habit to be back, this is why we should realize that our actions and words have many sides both positive and negative.

What spiritual disciplines would you like to try? What would you avoid?

Spiritual disciplines aim to help people to connect to God and develop this intimacy day by day. However, any discipline cannot start this relationship because people have no rights. Only God can take this step. These disciplines are powerful tools to achieve spirituality on the necessary level. I would like to take almost all disciplines and get a chance to be closer to God and his teachings: celebration (to evaluate my position), fasting (to learn personal inadequacies), meditation (to listen to God’s hints), prayer (to feel God’s heartbeat), etc. However, I try to avoid such discipline like sacrificing, because I have no right to take someone’s life even if God asks me to do this. All people are equal before God, and it is necessary, God does everything by himself.

Reference List

Vonderen, J.V., Ryan, D., & Ryan, J. (2008). Soul Repair: Rebuilding Your Spiritual Life. Downers Grove, Ill: InterVarsity Press.

There are many definitions of stress created by medics, psychologist, and counselors but none of them has come up with a concrete definition because stress consists of many things and also it is varies according to the environment.

Stress can be emotional or physical: Emotional stress happens when people are faced with challenging situations in their life such as loss of someone, unemployment, making critical decisions among others. Physical stress is usually due to emotional stress causing headaches, stomach aches, cramps, joints pain among other physical pain.

Stress management involves controlling stress levels and effects by reducing the tension that comes with stress. In dealing with stress one has to identify the source of it; after identifying the problem the best option to take as a first measure is to take a short break from it but not avoid it because that would be no solution.

Most of the causes of stress are issues that we can not avoid or escape: for example grief; the person won’t come back, Bills must be paid, books must be read, diseases can not be completely avoided, and relationships too are unavoidable and so are disagreements. The best solution therefore would be to find a solution to the tension that these issues cause.

One of the best ways is to exercise regularly so as to burn the excess energy in the body brought about by stress. Stress is excessive energy produced by our organs in response to compromising situations, this energy leads to increased respiration, blood pressure, tension in the muscles, dilated pupils and increased sugar levels.

It is therefore advisable to burn up this energy so as minimize it and Exercise also diverts the mind from the particular issue causing tension. Another way to handle stress is by sleeping; this helps to refreshes the body and also causes relaxation. A person suffering stress should sleep earlier than usual but not excessively. People with stress should also have short afternoon naps; they assist the mind to function better.

Another strategy would be to relax although not asleep; one should just sit by the fire side or near a lake or pool and meditate. This slows respiration rates, blood pressure and the muscles also relax. A person suffering from stress should avoid caffeine completely since it is a stimulant that will provide more energy to the tension hence elevating stress moreover caffeine is easy to give up because it is not highly addictive.

Reducing caffeine brings relaxation, less heartburn and one also sleeps better. Humor is also an effective way to handle stress because it releases tension by burning up excessive energy. People should also ensure that they eat well a balanced diet because many people often get malnourished when they are stressed (Bower & Segerstrom, 2004).

There also psychological issues that cause stress and by solving them stress can be completely avoided. Such issues are; common beliefs and life expectations that characterize the societies we live in. For example men believe that they should not show emotions because they will be considered weak.

This belief makes many of them to suffer in emotional stress since they cannot consult any one for help. If men would stop and think about their well being rather that their ego then they would not have to suffer stress. Another issue is the expectations we have concerning the society and our personal life.

Many people have dreams but some are unrealistic and they stick to them only to get disappointed by the reality of life. It is therefore advisable to set realistic and achievable goals that are within our reach to avoid disappointments that often lead to stress.

People should also embrace problem solving strategies so that when they are faced with conflict they can be able to solve the issue instead of letting it to build up tension in the body. There are many ways of stress management depending on the cause of the tension, the level, the environment and the available resources but those that are mentioned above are general and therefore apply to people of all kind (Gordon, 2000).

Reference List

Bower, J & Segerstrom S, (2004). “Stress management, finding benefit, and immune function: positive mechanisms for intervention effects on physiology”. Journal of Psychosomatic Research, 26-29.

Gordon, J, S, (2000). Stress Management 21st century health and wellness. Dublin: Chelsea House Publishers.

Introduction

Post-traumatic stress disorder (PTSD) is a psychological illness that is triggered by terrifying events, such as life threatening, frightening or extreme overwhelming experiences. These events may be associated with human or natural-caused disasters, personal assaults, military combat, and accidents among others.

Some other factors such as horror events and helpless situations among other can result to PTSD in a person who witness or experience them. PTSD keep on re-experiencing the traumatic occurrences and try to avoid contact with people, places, or other things that contributed to the disorder or which remind him of the events.

In addition, a person in this condition is delicate or sensitive to the happening of the normal world. Despite the fact this condition is serious and has ever existed, human being has tolerated trauma and as a result this condition has made it hard to identify a person suffering from post-traumatic stress disorder and has therefore been termed as a formal diagnosis for a long time.

This condition has been nicknamed with many terms, for instance “soldier’s heart” condition by early American civil war veterans, “combat fatigue” in World War I, “gross stress reaction” in World War II, “post-Vietnam syndrome” by early Vietnam troops, “shell shock” and “battle fatigue.” (Frienman 2003).

Statistical facts on PTSD

A severe post traumatic stress disorder normally results from an extended exposure to events causing trauma and it is associated with long-term problems with damaged social and emotional functions. According to survey done by Nutt, Davidson and Zohr (2000), 7% – 8% of the US citizen will likely experience PTSD throughout their life with other cases of rape and combat veteran’s victims comprising of 10% – 30%.

The survey also shows that in a nation that comprises more than one ethnic group such as America, some ethnic groups are more affected as compared to others. This is caused by different ways in which these groups practice ways of socializing, perception of inferiority by some ethnic groups, individuals self blaming as a result of perceiving themselves as minorities and ways of expressing stress which differs between these groups.

In addition, since the minority groups are the most sufferance of conditions such as low self esteem, they are more likely to join sub-cultural groups such as army, at early age, something that expose them to PTSD. More importantly, women are considered to be more sensitive to PTSD as much as twice in comparison with men. In regard to the children and teens, research has shown that about 42% have undergone and endured at least one traumatic event with girl comprising the highest percent.

Causes of PTSD

Any trauma related to psychological or emotional well being of an individual, life threatening event or extreme fear can result to PTSD. According to Frienman (2003),

“These occurrences entail witnessing or experiencing physical injury, stern accident, exposure to war combat or a natural disaster, a medical diagnosis which is life threatening, victimization in kidnapping or sexual harassment such as rape, torture, terrorist attack experience, being exposed to cases of robbery, emotional abuse, and involvement in civil conflict.”

In addition, other events which might not be categorized as traumatic such as unemployment, and divorce and others could also make people develop PTSD in reaction with them (Schiraldi 2004).

Signs and symptoms of PTSD

There are three symptoms of PTSD: First, repeated or continuous trauma experience such as; flashbacks caused by recalling of the traumatic events, troubled memories, progressive nightmares about the trauma and dissociated trauma relieving;

Second, avoidance of people, places and experiences associated with the trauma or which bring back memories of trauma to an extent of developing a phobia on them; and thirdly, according to Schiraldi (2004), “chronic physical signs of hyperarousal, which include difficulty in recalling things or blackout, anger, insomnia, increased tendency and reaction to being started, poor concentration, irritability, hypervigilance to heat , and trouble concentrating.”

Assessment of PTSD

Although most of PTSD victims complain about of different symptoms with those of PTSD making it sometime hard to assess the disorder, PTSD is assessed through various ways. Mostly, the ‘patients’ complains are on depression, somatization (body symptoms), and drug addiction.

It is argued that individuals suffering from PTSD have cases of attempting to committee suicide. In addition according to Flannery (2004), “to these symptoms, the diagnosis of PTSD is often accompanied with habits of eating disorders, anxiety disorder such as social anxiety disorder, obsessive compulsive disorder, generalized panic disorder, and panic disorder.”

In examining PTSD in a teenager, interviewing both the teenager and his or her guardian separately is very important as despite that parent may be having certain perspective, the child may be undergoing natural feelings that the parent is not aware of.

Sometimes children may present different symptoms of PTSD from adults which make it difficult in diagnosing them. For example, their symptoms may comprise of problems in focusing, sitting still or controlling their impulses, which is not common on adults, and these symptoms can be mistaken with other body disorder (Nutt et al 2000).

What are the Effects of PTSD

Traumatized person is exposed to significant consequences raging from milled one to serious ones According to several psychologists’ researches; people who have undergone severe stress have smaller hippocampus (a brain part that enhances memory) as compared to people not exposed to traumatic events.

According to Schiraldi (2004), “since the hippocampus is the key brain part that plays the major role of recalling the happening of events, it makes it important in understanding the trauma effects in general and specifically, the impact of PTSD.”

In addition, persons who have been exposed to traumatic events, regardless whether the condition develops to PTSD or not, they are exposed to risks of unhealthy consumption of drugs such as alcohol, cigarettes and marijuana. If PTSD is ignored and fails to be treated, it can lead to disturbing consequences which widely affects not only the PTSD victim but also the relationships of the victim with his family and the society in general (Kinchin 2004).

These effects are more serious to women who suffer from sexual harassment in their early childhood, effects which can be inherited by their children. For example, a mother with this disorder in her pregnancy period will likely give birth to a child who will suffer from PTSD due to chemical imbalances.

This disorder also results to other illnesses such as stomach ulcers and reproductive problems among others. According to Goulston (2007), “Individuals suffering from PTSD struggle emotionally to acquire good mental health treatment outcome similar to any other person with any kind of emotional problem.” PTSD also affects the learning abilities and social aspects of children and teens.

In addition PTSD affects, at a great extent, children’s ability to learn. PTSD can also contribute to economic problems. For example, in 2005, a number of veterans exceeding 200,000 received compensation of disability of this illness which amounted to $ 4.3 billion (Kinchin 2004).

Protective factors and risk factors for PTSD

According to Kinchin, (2004), “there are issues which contribute to high risk of people in developing PTSD which include: higher severity of experienced trauma; a prolonged duration of trauma event; lack of enough social support from family and friends; many endured traumatic events; and having an emotional condition before the traumatic event.” Other factors that contribute to PTSD include conditions of handicapped on individuals and home violence.

On the other hand, preventive factors may include offering training useful for improving traumatic related logistical issues and physical safety. This is the reason why people in working professional fields with prior knowledge of happenings are less affected by post-traumatic stress disorders when they encounter a disastrous event as compared to those with no such professional training.

On the other hand, use of medicine is another way of preventing PTSD. These medicines include those that reduce extent of depression and heart beat among others. However, these medicines have to be administered into an individual immediately on the traumatic attack (Goulston 2007).

How PTSD is treated

In treating PTSD, two measures can be employed which are medical and psychological measures. In psychotherapy, the treatment entails educating the sufferer concerning his or her condition, assuring the patient of other cases by other people, providing guidance on ways of managing the accompanied symptoms, as well as helping the sufferer to view his condition from a positive perspective.

According to Nutt et al (2000), “in educating the PTSD sufferers, they are explained what PTSD is, number of others suffering the illness, its actual cause which is not weakness but extraordinary stress, its treatment and expectations in treatment.” This education is helpful in dispelling any misleading ideas conceived by these individuals.

On the other hand, medicines can be used to treat this illness. Some of the medication used include; serotonergic antidepressants, propranolol, clonidine and paroxetine. Many of these medicines help the sufferer absorb and retain information as well as assist in decreasing fear, depression, anxiety and panic (Flannery 2004).

How to Cope with PTSD

One way of copping with this condition is through assisting the patient to understand it, encouraging him to speak his feelings out and directly. He can choose to do this by talking to his friends, family members of health professionals. In addition, it is considered healthy joining a support group. More importantly, an individual should apply relaxation techniques effective for managing stress, such as positive imagery and breathing exercises.

Other tips include, healthy eating, adhering to professional recommendations on treatment, volunteering, increasing lifestyle practices which are positive, and minimizing lifestyle practices which are negative such as substance abuse, excessive working, and negative thoughts among others (Frienman 2003).

In addition, other people mostly “significant others” are key players in helping a PTSD sufferer in coping with this condition. Offering social support to the individual helps him/her to perceive himself in a positive way by appreciating the support and identifying him/herself with another person or party. The significant others which mostly comprise of family members such as parents in case of children and partner in married couples will determine whether the victim will be able to cope with the situation or not.

Any signs of discrimination from them to the victim such as stigmatization and avoidance will accelerate the intensive of the disorder. On the other hand, support through listening and encouraging the sufferer to speak out, involving him in social activities and sticking near him will not only provide psychological support but also but also a good ground for adjustment.

Reference List

Flannery, R. (2004). Posttraumatic stress disorder: The Victim’s Guide to Healing and Recovery. Ellicott City: Chevron Pub Corp.

Frienman, M. J. (2003). Post Traumatic Stress Disorder: The latest assessment and treatment strategies. Alexandria: Compact Clinicals.

Goulston, M. (2007). Post-Traumatic Disorders for Dummies. Alexandria: For Dummies.

Kinchin, A. (2004). Post Traumatic Stress Disorder: The Invisible Injury. Baltimore: Success Unlimited.

Nutt, D. J., Davidson, J. R & Zohr, J. (2000). Post-traumatic stress disorder: diagnosis, management and treatment. Washington, DC: Informal Health Care.

Schiraldi, G. R. (2004) The Post-Traumatic Stress Disorder source book. Bethesda: McGraw Hill Professional.

The correlation between stress and headaches has been studied for a long time, and a lot of literature considering this correlation exists. Nevertheless, the study in this area should be held since it is still not clear which types of stress provoke which types of headache, in order to prevent or, at least, overcome the headaches. Here the experiment will be introduced

First, it is necessary to determine the methodology of the experiment, and, secondly, it is important to state that it has already been “a common clinical observation” that stress is “associated with the onset and severity of headache” (Hubbard & Workman 166).

On the ground of the present experiment lies the experiment mentioned in Handbook Of Stress Medicine: An Organ System Approach when a woman experiencing stress art home everyday write down the stress itself which caused the headache, and each headache she was struck by (Persons 186). The result of the experiment mentioned above was the observation that stress caused the headache occurring the next day, and continuous stress caused intensification of headache.

The experiment consists in continuous provoking of stress in people of 17-20 years old. This age is chosen since people in this age have strong health. It is also important that these people didn’t have any physical disorders (problems with tension, etc.) and, of course, any mental disorders (insomnia, epilepsy, etc.). These, let it be, 10 people must spend two hours a day at hospital during a month. Each of this ten must help medical staff to take care of a group of children suffering some cancer.

The continuous staying in environment of the hospital itself and witnessing children’s really hard state will cause psychological stress in people involved in the experiment: already in few days, may be in a week, headache will appear. It is also necessary to ask the ten to start diaries, where they are to write about the events, taking place in the hospital; express their feelings and their state/health or changes in their state/health. It should be stressed that these diaries must be detailed.

First of all, these writing will be useful for observation, since it will be possible to detect the starting point of headaches; on the other hand, it will make these people recollect stress causing events and enhance their stress. After a month of the experiment it is possible to stop and take the diaries for study, and take interviews with the ten people.

In a month or even 2 weeks after the ending of the experiment it is necessary to take another interview with these people. During this interview it is necessary to find out whether each of ten has headache, and it is also important to determine whether they had some stress causing situations or events.

Supposedly, at the end of the experiment almost all of ten people will have headaches during the experiment. And in few days after they stop visiting hospital headaches must be gone, since the stress causing factor was gone. This experiment will prove the statement that psychological stress causes headache.

Another value of this experiment lies in the fact that it will be possible to detect possible ways of overcoming headaches, caused by such situations. This in its turn will help medical stuff to avoid headaches caused by the situations which they have to witness each day due to the peculiarity of their profession.

Works Cited

Persons, J.B. The Case Formulation Approach to Cognitive-Behavior Therapy. New York: Guilford Press, 2008.

Hubbard, J.R., Workman, E.A. Handbook of stress medicine: an organ system approach. New York: CRC Press, 1998.

Man has had to deal with numerous challenges as far as remaining healthy is concerned. Researchers have been able to identify several causes of health problems among human beings and most of them have grave consequences. Stress has been singled out by most investigators as being one of the major causes of both physical and emotional health problems (Niess, Monnikes, Dignass, Klapp, & Arck, 2002). This has been escalated by the frequent hassles, frustrations, and demands in the day to day life experiences.

Attempts to handle all these challenges may end up being overwhelming hence creating a general imbalance in an individual. Reasonable levels of stress have been clinically determined as being helpful particularly when faced with a challenging task like a presentation, examination situation, and deadlines since one becomes alert, energetic, and at full concentration.

However, reliable studies have established that extreme/chronic levels of stress can be destructive to a person’s physical and emotional health thus affecting the general productivity, relationships, as well as the quality of the person’s life in general. The research paper will explore the various effects of stress on an individual’s health.

According to many research findings, prolonged incidences of stress can have serious impacts on an individual’s health. Extreme levels of stress have the capacity of disrupting virtually the entire body system and its functions. Among other effects, stress can increase the rate of heart beat, paralyze the immune system, the risk of heart attack and stroke, affect a person’s fertility, and raise the general levels of fatigue and aging rate.

A research conducted by Hapuarachchi, Chalmers, Winefield, and Blake-Mortimer (2003) found that high levels of oxidative stress, a pro-inflammatory state, high infection rate, and cardiovascular diseases were mostly due to stress.

Hapuarachchi and the team also established that homocysteine, and the levels of C-reactive protein (CRP) may lead to cardiovascular infections. They arrived at these conclusions after investigating the relationships that may exist between stress and homocysteine, oxidative stress and CRP.

High levels of CRT and increased levels of pro-oxidant and pro-inflammatory states increase the levels of psychological stress (Hapuarachchi et al., 2003). The study findings further indicate that the levels of anger can be influenced by the levels of homocysteine.

A similar investigation was done by Macleod, Smith, Heslop, Metcalfe, Carroll and Hart (2002) with the objective of finding out the association between self reported psychological stress and cardiovascular disease. The researchers engaged Scottish men only with follow up of about 21 years.

According to the research findings by Macleod et al., there is greater relationship between higher stress, angina, and some of the hospital admissions (2002). However, critical analyses of the findings in relation to heart disease findings have revealed the impact of reporting bias.

Psychological stress, among other psychosocial factors, has been identified by many researchers as playing a role in determining heart-related diseases. This is because stress affects the neuroendocrine mechanisms and cause unhealthy behavior in the victim (Macleod et al., 2002).

Research findings reveal that there is a strong relationship between self reported stress and self reported signs and symptoms of coronary heart disease. Furthermore, there is a relationship between stress and the number of admissions to hospitals for psychiatric disorders.

The correlation between higher levels of stress and angina was also found to be positive. The findings were considered to be under the great influence of reporting bias from the participants leading to high tendency of spurious conclusions as far as psychosocial constructs and health outcomes are concerned (Macleod et al., 2002). It is this critical evaluation of research findings that has helped in the quest for more objective investigations of the association between stress and health outcomes.

Most recent researches have made attempts to investigate the effects of stress on the mental stability of an individual. Robert Soufer, a renowned stress researcher, studied how the brain copes with neurocardiac interaction during stress-induced myocardial ischemia (2004). According to Soufer, the administration of acute mental stress can provoke myocardial ischemia in persons with coronary artery disease (CAD).

A person’s brain is responsible for coordinating memory ability and hence determines an individual’s vulnerability to the cardiovascular manifestation of emotional stress. In deed, the brain’s neurochemical pathways associated with inappropriate fear and anxiety are responsible for cardiovascular effects of stress. In some instances, the brain may trigger inappropriate responses to various stimuli resulting in stress/fear which in turn affects the person’s physical health (Soufer, 2004).

Apart from investigating the role of stress in heart-related health problems, researchers have also sought to find out the influence of stress on immune system of an individual. Niess et al. (2002) conducted a study on the role of stress on immunological diseases and related health problems.

For a long time, stress has been known to significantly influence the continued inflammatory bowel disease. The researchers’ intention was to find out the validity of this belief. Earlier studies have found that stress greatly affects the immune system.

The neuroendocrine system as well as the intestinal epithelia is also known to be escalated by stress. More so, stress has been known to initiate the discharge of pro-inflammatory Th1 cytokines and neuropeptides which include tachykinins (Niess et al., 2002).

It is widely believed that if the neuroendocrine system interacts with the immune system, the intestinal epithelium may be affected resulting in the stimulation of IBD relapses. Prior studies have strongly associated the cause of relapses of ulcerative colitis to stress.

The research by Niess and colleagues had the objective of finding out the significance of psychoneuroimmunological (PNI) approach as far as the pathogenesis of IBD is concerned(2002). A number of studies have traced how stress affects the immune system to the ability of stress to alter the body’s immunological orientation, particularly by affecting the distribution of lymphocytes and the synthesis of cytokines.

Stress can also affect other mediators and mechanisms, such as the neurotransmitters, the hormones, and other immune cells which in turn lead to imbalance in the entire body. It is the various body systems that are responsible for responding to and balancing the otherwise extreme (chronic) levels of stress (Niess et al., 2002). The review done by Niess and his team helps in concluding that stress plays an important role in the emergence of several immunological diseases; the immune and the nueroendocrine systems.

The research paper has explored the various effects of stress on the physical health of an individual. Stress has far-reaching effects, such as causing or enhancing cardiovascular diseases, coronary heart disease, and myocardial ischemia. The paper has also explored the effects of stress on the immune system and the neuroendocrine system.

Many researchers agree that chronic stress plays a significant role in some of the health problems that people encounter from time to time. It can be concluded that the findings on the effects of stress on the physical and emotional health of people are still varied and complex and further objective studies must therefore be carried out if meaningful conclusions are to be reached.

References

Hapuarachchi, J. R., Chalmers, A. H., Winefield, A. H., & Blake-Mortimer, J. S. (2003).

Changes in clinically relevant metabolites with psychological stress parameters. Journal of Behavioral Medicine, 29, 52-59

Macleod, J., Smith, G. D., Heslop, P., Metcalfe, C., Carroll, D., & Hart, C. (2002).

Psychological stress and cardiovascular disease: empirical demonstration of bias in a prospective observational study of Scottish men. British Medical Journal, 324: 1247-51

Niess, J. H., Monnikes, H., Dignass, A. U., Klapp, B. F., & Arck, P. C. (2002). Review on

the influence of stress on immune mediators, neuropeptides and hormones with relevance for inflammatory bowel disease. Digestion, 65, 131-140

Soufer, R. (2004). Neurocardiac interaction during stress-induced myocardial ischemia: how does the brain cope? Circulation, 1710-1712. American Heart Association, Inc.

Introduction

The study ‘Randomized Trial of Cognitive-Behavioral Therapy for Chronic Post-Traumatic Stress Disorders in Adult Female Survivors of Childhood Sexual Abuse’ purposed to compare the efficacy of three treatment strategies – the cognitive-behavioral therapy (CBT), the present-centered therapy (PCT) and the wait-list (WL) – on women with posttraumatic stress disorder (PTSD) arising from childhood sexual abuse.

The nature of the problem discussed in the study therefore revolves around developing proper treatment methodologies for victims of childhood sexual abuse (CSA) who developed PTSD due to their perceived inadequacies to overcome the trauma related to CSA.

Previous controlled trials had adequately revealed the effectiveness of individual CBT for men exhibiting combat-related PTSD, women with PTSD resulting from rape ordeals, and women exhibiting symptoms of PTSD arising from sexual and nonsexual assaults (McDonagh et al 515).

Previous studies had also demonstrated the efficacy of CBT on men and women with PTSD arising from a multiplicity of traumas. A previous study employing the wait-list (WL) had also provided preliminary verification that WL was effective in imaginal exposure heralded by affect-regulation and interpersonal efficacy skills training on adult females (McDonagh et al 516).

However, in spite of the fact that there exist a wealth of clinical literature on treatment methodologies of victims of sexual abuse, the evidence base concerning the treatment of victims of childhood sexual abuse (CSA) exhibiting symptoms of PTSD is considerably limited.

The current research therefore aimed to add critical knowledge on which treatment methodology, between CBT, PCT, and WL is most effective in the treatment of women with PTSD arising from childhood sexual abuse.

As such, the authors came up with a hypothesis that “…CBT would be more effective than PCT and WL in (a) reducing interviewer-rated PTSD symptoms; (b) reducing self-reported depressive, anxiety, dissociative, and anger symptoms, as well as cognitive distortions; and (c) improving quality of life” (McDonagh et al 516).

The independent variables included: History of childhood sexual abuse, demonstration of some intrusive and avoidance symptoms of PTSD directly related to childhood sexual abuse, gender (women), and demonstration of one comprehensible and detailed memory of childhood sexual abuse.

The dependent variables included: Intensity and frequency of PTSD symptoms, coexisting Axis 1 and Axis 2 disorders, depression, level of disruptions of beliefs about self and others, level of dissociative symptomatology, level of state anxiety, state and trait anger, and quality of life.

Methods

According to McDonagh et al “…both the CBT and PCT treatments were operationalized in manuals and conducted in 14 individual sessions, the first 7 of which were 2 hr long, and the final 7 of which were 1.5 hr long” (518).

The longer than 1-hr treatment sessions were intended to provide the interviewers with adequate time to elucidate attenuation of anxiety in participants during exposure sessions. After undergoing a rigorous training exercise, distinct groups of female clinicians were charged with the responsibility of providing CBT and PCT treatments to participants.

All therapy sessions were tape-recorded for later review by an expert in the treatment. The participants assigned to the WL treatment were advised that they could obtain their preference of the two treatment strategies in about 14 weeks after they had successfully completed the post-WL evaluation.

In addition to meeting the compulsory requirements for the independent variables mentioned above, the74 women who were selected to take part in the study had to meet some set standards or criteria, namely: non-current use of medication that have considerable effect to the autonomic nervous system; currently not pregnant; no known cardiovascular condition, free from conditions such as mania, hypomania, severe depression, schizoaffective disorder and other related disorders; free from alcohol or drug abuse; no withdrawal symptoms associated with benzodiazepines, alcohol or drug use three months prior to the consideration for enrollment into the study; absence of active suicidal orientation; and absence of an abusive relationship with an intimate partner (McDonagh 516).

As already mentioned, treatment groups were divided into three – cognitive-behavioral therapy (CBT), present-centered therapy (PCT), and wait-list (WL).

The fundamental components in the treatment procedures for CBT included PE, in vivo exposure and CR, not mentioning that imaginal exposure was commenced in the fourth week of treatment involving attempting to remember the traumatic event with much clarity as possible, recitation of the traumatic event to the clinical therapist in the present tense, and constantly going over the memory until the anxiety or distress subsidized (McDonagh 518).

Psycho-education was also provided to the participants. Treatment protocols for PCT were specifically designed to describe an active therapeutic intervention that could be employed by non-CBT clinicians in the effective treatment of PTSD-CSA. Treatment procedures for WL revolved around the wait-times.

Dependent variables were measure using a wide array of data gathering tools, including: CAPS; SCID; ELS; The Beck Depression Inventory; The Spielberger State-Anxiety Inventory; The Traumatic Stress Institute Beliefs Scale; The Dissociative Experiences Scale; The Cock-Medley Hostility Scale; The State-Trait Anger Expressive Inventory; and The Quality of Life Inventory (McDonagh et al 517).

Results

There was a significant dropout rate in the course of the study, standing at 23 percent. Analysis revealed that PTSD severity as measured by CAPS did not vary between CBT dropouts and those who completed the study, but statistically significant variations were reported on all the other psychometric measures.

It is of if importance to note that the CBT dropouts citied high levels of depression, anxiety and low quality life than those who completed the treatments (McDonagh et al 519). In terms of intention-to-treat analysis, 27.6 percent of subjects in CBT, three in ten in PCT, and about 17.4 percent in WL no longer met the standards set for PTSD. Post hoc analysis of the TSI and CAPS demonstrated that participants in CBT and PCT improved considerably when compared to those in WL.

A follow-up analysis taken three months after treatment demonstrated that 82.4 percent of subjects enrolled in CBT and 42.1 percent enrolled in PCT no longer met standards for PTSD, implying that had developed adequate coping and problem-solving strategies to deal with their distress. At 6-month follow-up, just above three-quarters (76.5 percent) of subjects in CBT and 42.1% in PCT no longer met the criteria for PTSD.

McDonagh and colleagues also found out that “…on measures of anxiety, depression, dissociation, anger, hostility, and cognitive distortions, CBT was comparable with PCT at all post-therapy assessments” (519).

Discussion

The researchers’ hypothesis that CBT would be more effective than both PCT and WL received consistent support across the various measures employed to evaluate posttraumatic and related symptomatology.

However, the findings came up with new knowledge that PCT is consistently more effective in treating PTSD than WL when measured using the scales explained above. According to McDonagh et al, “…both treatments resulted in marked improvements in PTSD symptom severity, state anxiety, and trauma-related cognitive schemas, all of which showed little change for the WL participants” (520).

It should be noted that both CBT and PCT never proved their superiority over WL in terms of curtailing symptoms of depression, dissociation, aggression, anger, and enhancing the quality of life. All in all, a conclusion can be made that CBT has a considerable positive impact on the treatment of PTSD symptoms for adult female victims of CSA, but the high dropout rate in CBT brings in another dimension that women were more unwilling to complete CBT than other treatment procedures.

The study also adds to our current knowledge by demonstrating that the effectiveness and tolerability of PCT, which utilizes education on the impact of trauma and facilitation of learning skills to enhance social coping strategies, may be an effective non-CBT strategy towards the treatment of PTSD that is largely viewed to be secondary to CSA (McDonagh et al 522). The study was decisively limited by the considerable dropouts especially in CBT

Personal Reflection

The study utilized scientific procedures to reach a conclusion that CBT was still the treatment of choice for PTSD symptoms related to CSA. However, it must be noted that PCT demonstrated remarkable results in the treatment of PTSD symptoms secondary to CSA and, thus, it should be included in conventional treatment methodologies for PTSD. By and large, the methodologies adopted for the study were able to adequately test the initial hypothesis.

However, it must be said that the researchers employed many measurement procedures that are likely to confuse readers. It is my personal belief that the consistent findings could be achieved through the employment of a few standardized measures. However, future research is needed to demonstrate why many women survivors of CSA opt out of CBT and instead prefer PCT.

Works Cited

McDonagh, A., McHugo, G., Sengupta, A., Demment, C.C., Schnurr, P.P., Friedman, M., Ford J., Mueser, K., Fournier, D., & Descamps, M. Randomized Trial of Cognitive-Behavioral Therapy for Chronic Post-Traumatic Stress Disorder in Adult Female Survivors of Childhood Sexual Abuse. Journal of Consulting and Clinical Psychology 73.3 (2005): 515-524

Introduction

Post-traumatic stress disorder (PTSD) is an emotional / anxiety disorder that normally affects individuals who have experienced an extremely stressful or frightening ordeal. It is commonly a result of psychological stress.

McIntosh states that, trauma that really threatens one’s mortality and one that extremely compromises with the normal emotional health of an individual, is bound to cause post-traumatic stress (4). As the name of the disorder suggests, it is stress that happens after a person experiences extreme fear or trauma. Those who suffer from this disorder usually re-live or re-experience the ordeal that triggered the trauma.

These individuals often come up with defensive mechanisms that help them forget these experiences even though for a short period. Tim O’Brien’s novel In the Lake of Woods shows us the effects of the Vietnam War on a former American soldier called John Wade. He exhibits the characteristics of Post-traumatic Stress Disorder. The rage that causes him to inadvertently scream “Kill Jesus” is suppressed to the “forgetting tricks” throughout the novel.

Background

The novel tells of a sad story of post-traumatic stress disorder as experienced by John Wade, a Vietnam War veteran. The main concept of the book revolves around John Wade’s experience through flashbacks including his abused childhood. As John grew into a man, he became involved with a woman by the name Kathy.

In their relationship, both kept many secrets from each other. For instance, Kathy hated her marriage to John Wade, had an affair with the dentist of which John was aware and how John had the habit of spying on his wife. Thus, their relationship was built on deceit, concealment and illusions. Furthermore, during the war, John wrote letters to Kathy, he stated to her in pride of his involvement in a massacre of a village as well as his identity as the Sorcerer.

Symptoms of PSTD and coping strategies

The three principal groupings of the most common characteristics symptoms of PTSD are re-experiencing/relieving the traumatic event, emotional numbing and avoiding reminders of the traumatic experience. Many occurrences in war happen suddenly and unexpectedly. These occurrences do not give the one experiencing them enough time to conform psychologically to the sudden change (McIntosh 9-11) thus leading to PSTD. Similarly, John Wade exhibits these characteristics after having gone through the Vietnam War.

Relieving traumatic events

He relieves the traumatic event of the Vietnam War. Consequently, after John came back home from Vietnam, he gets a job in records within which he destroys any evidence of his involvement in the My Lai massacre. He concealed his involvement to gain a position as lieutenant governor of the state of Minnesota as well as a United States senator but lost miserably.

John’s Vietnam ordeals continuously haunt the couple as they settle in their cabin house following John’s defeat. John even forces his wife to have an abortion even thou she really would love to have children. He kills his unborn baby just like those helpless villagers in Vietnam during the massacre.

Emotional numbing

John exhibits emotional numbing and cannot feel what is going on around him. This is a coping strategy of victims of PSTD as Peters, in his article urges that the individual becomes ‘numb’ to the environment around him and the normal emotions experienced by a normal person become nonexistent to them (6-7).

As a symptom, to his depressing state, we find that he unknowingly carried the kettle of boiled water into the bedroom to watch his sleeping wife. “It was almost a fact, but not quiet, that he moved down the hallway to their bedroom that night, where for a period of time he watched Kathy sleep…” (O’Brien 188-189). John seemed out of touch with his actions as well as his environment. Apparently, John felt a numbness inside him that traveled to his mind and a feeling of not quite caring about his actions. “Odd, he thought.

The numbness inside him. The way his hands had no meaningful connection to his wrist” (p.50). This numbness, of not feeling the twisting of his wrist, indicates that he was not even aware of his destructive action of pouring the water from the kettle. He is not aware whether Kathy woke up or not. We as the readers are not even sure what is real or John’s figment of imagination. “In the dark she seemed to smile at him.

Then she jerked sideways, puffs of steam rose from the sockets of her eyes. Impossible, of course” (p.84) – this part particularly shows the level of disorientation that John suffered as he did not seem to understand his horrible action of burning his wife. The way John viewed the scenario in the dark was obviously so inaccurate that he mistook Kathy’s look of pain for a smile. He did not realize that the steam rising from her eyes was a sign of the burning that was taking place.

The book was written in John’s viewpoint and the use of words “impossible, of course” show that to him, the puffs of steam rising from his wife’s eyes were just unreal allowing his continuing of burning her to death. John was not even moved by his actions the next morning.

The following day he does an action so absurd that we are shocked. John did not even remember that he had dumped the body of his wife in the lake. His forgetfulness about killing his wife and concealing her body is a forgetting trick that the author uses in the novel to show us how the PSTD victims conceal or deny their actions. Thus, John avoids dealing with this possible horrific action.

Avoiding reminders of traumatic experiences

People suffering from PSTD avoid reminders of the traumatic experience. In John’s case, he tries to avoid remembering the traumatic experience of killing of his wife by getting involved in a search team and questioning his neighbors about her whereabouts.

However, on pages 131 to 132, “He remembered the weight of the teakettle. He remembered puffs of steam in the dark…the steady lap of waves against his chest…Absurd, Wade thought”. At this point, John saw it as absurd that there was steam rising in the dark, a scenario that any normal person would have realized as coming from the extremely hot water he was pouring.

We have seen that a post-traumatic stress disorder victim has frequent periods of lapsing memory and a mind that is disconnected from the normal occurrences of life. Such an individual like John Wade will suffer disorientation throughout his life. Though having forgotten sinking his wife into the lake, he gets flashes of the events that occurred that night as time moves on.

Later he wakes up in the deep night and goes to the boathouse where he feels that something horrible had happened at that place only that he did not remember what it was. “…as sense of pre-memory washed over him. Things had happened here. Things said, things done…” (188).

On page 242, however, he seems to remember everything even where his alleged missing wife is “He didn’t think about it. Quick, he stripped naked and filled his lungs and dove to the bottom where Kathy was.” Disturbingly, John thought of his dead wife as he would if she were still alive as he swam towards her body.

“From the bottom of the lake, eyes wide open, Kathy Wade watches the fish fly up to swim in the land of sky blue waters…” (286). He thought that she was looking up at him and that she was swimming. “Kathy stares up at him from beneath the surface of a silvered lake…she swims in the blending twilight of it in between” (288).

On page 283, it seems that John is now aware of his actions but still has some sense of denial “Had he harmed her? Well no, but yes”. Of course, he knew he had harmed her but he seemed to justify that he had done it in his sleep meaning he did not mean to do it. “He was Sorcerer. He was guilty of that, and always would be….” Meaning he still identified himself with the person, he was in Vietnam. He still was the person who made things disappear and vanish. He still was the man who wanted to kill.

Blocking traumatic experiences

The other coping strategy that PSTD sufferers use is blocking the traumatic experiences from the mind. Victims of post-traumatic stress disorder usually try to block out intrusive memories of the occurrence, feelings that re-animates that event into the current as well as feelings of severe anguish on recalling the traumatic event (McIntosh 9).

The traumatic experiences are pushed back into the subconscious and the victims often forget some of the traumatic events although this does not mean that the memories go away forever as they can be revived by watching horrific scenes involving war on television and some of the war veterans have suffered by seeing similar war horrors (Peters 4). Moreover, Vietnam War veterans are known to have memories and nightmares associated with the war experiences.

They become so caught up in these memories that they find difficulty in focusing on present and events around them. The veterans say that their dreams often involved terrifying memories of the Vietnam War and other horrible nightmares not related to the war. The veterans avoid people and events that remind them of the war even decades after the war ended. They attempt to block off these memories and distressing feelings arising from the memories.

This leads to withdrawal from the family circle, their friends as well as the entire society (McIntosh 9). This may explain why John withdrew into the Lake to try to escape from the haunting experiences although his bid failed. John tried to block out the memories of Vietnam and some of the horrific secrets about the war are buried deep inside in his memories.

However, the effects of war leave an indelible mark on the veterans’ minds and lives and John was no exception and often suffered from blackouts as well as nightmares. He would wake up yelling because of recalling horrors about the atrocities that he took part in during the Vietnam War. Eventually the horrors led him to kill his wife an action that he would otherwise not have likely committed had he not been haunted by the Vietnam horrors. He cannot escape from the undead memories of the war.

Conclusion

War veterans suffer from PSTD and in most cases; they end up committing unforgivable acts. Most are unable to cope with the traumatic events that they experience while at war and thus there is a need to help the veterans overcome the trauma and fit into the normal life once the war is over.

John does not recover from the PTSD and kills his wife Kathy in cold blood. He symbolizes the horrors of war that continue long after the war is over. O’Brien captures John’s coping strategies- re-experiencing/relieving the traumatic event, emotional numbing and avoiding reminders of the traumatic experience- using “forgetting tricks” in a compelling way.

Works Cited

McIntosh, Steven. “Posttraumatic Stress Disorder (PTSD) and War-Related Stress” Information For Veterans and their Families (2000): 4-20. Web.

O’Brien, Tim. In the Lake of the Woods. New York: Penguin Books, 1995.

Peters, Roger, F. Casualties of War: Vietnam War Veterans PTSD and Depression. Human Focus Group, 2003. Sept. 13. 2003. Nov. 11. 2010. http://www.heas.com.au/downloads/casualties_of_war.pdf

In the years following the 9-11 terrorist attacks, posttraumatic stress disorder (PTSD) gained wide spread concern, and today, this disorder that has undergone a great deal of research in psychology and related literature.

The relationship of this disorder with past trauma, and the method of reducing the effect of PTSD through psychological treatment and medication, has been studied by various scholars in the discipline. Although there has been a considerable amount of research on the topic since its official recognition as a disorder in 1980, most of our knowledge about PTSD has come from returning war veterans.

In addition, some of this research indicates that the differences in the degree of the disorder are due to the varying nature of the trauma experienced by that individual. This paper is a critical study of a peer-reviewed article on PTSD that aims to understand the nature of empirical research on PTSD and deduce inferences regarding the effectiveness of these researches.

PTSD research has also tried to understand the effect of previous trauma on PTSD victims and its effect on subsequent exposure to trauma. A study conducted by Breslau, Chilcoat, Kessler, & Davis (1999) tried to ascertain the effect of childhood trauma on trauma infested Vietnam veterans. The research collected a large sample of 2181 individuals who were interviewed over the telephone.

They used randomly selected index trauma to detect PTSD. The results of the study indicated that individuals who have traumatic experience in childhood were at a greater risk on exposure to subsequent trauma and at greater threat of PTSD. The empirical study thus pointed out that an individual who had experience childhood violence was more likely to experience PTSD in adulthood.

The study indicates that the intensity of PTSD is affected by the number of previous traumatic events in the individuals’ childhood, recency of the traumatic event, and the nature of previous trauma. Empirical research suggested that higher number of exposure to trauma led to greater possibility of PTSD in individuals. It also indicated one isolated exposure to trauma did not hold high risk for the disorder to occur.

Further, the research indicated that individuals were at higher risk of PTSD, if they had single or multiple exposures to assaultive violence previously. The research also indicated that in case of assaultive violence such as rape or combat in childhood, individuals were at greater risk, approximately within 5 years period, of PTSD.

The data analysis was done on randomly selected 1922 respondents who experienced previous trauma since the age of 5 years. The research findings show that the risk of PTSD depended on the type of index trauma. In this assaultive violence concurred greatest risk. Further, the research also showed no significant relation between age and PTSD.

The research findings supports the initial hypothesis that previous traumatic even causes greater risk of PTSD in case of subsequent trauma. The research indicates that when individuals were exposed to assaultive trauma in their childhood, it has greater association with PTSD. However, the limitation of the study is its hypothesis from the previous researches on PTSD.

The research shows that the victims who had been exposed to previous trauma are at a greater risk of PTSD in case subsequent trauma. The empirical research using a vast number of respondents demonstrates the effect of previous trauma is higher in case of assaultive violence. This research too confers the findings by Breslau et al. (1999).

References

Breslau, N., Chilcoat, H., Kessler, R. C., & Davis, G. C. (1999). Previous Exposure to Trauma and PTSD Effects of Subsequent Trauma: Results from the Detroit Area Survey of Trauma. American Journal of Psychology, 156(6) , 902-907.