Post Traumatic Stress Disorder or Combat Fatigue

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Introduction

Anxiety is a condition caused by a feeling of fear and tension, and it may be accompanied by headaches, chest pains, shaking among others. Generalized Anxiety Disorder (GAD) is one of the disorders that are accompanied by anxiety. In this disorder, anxiety is normally high and frequent, with stress accumulating from work and home cores as a result of minor issues. Symptoms of GAD include restlessness, irritability, tiresomeness, insomnia (which entails difficulty in sleeping), and poor concentration. The main causes of GAD may vary from a stressful experience in life such as a family crisis, traumas from childhood experiences such as a parent’s death, and in some cases, it is hereditary (Bourne, 2005, pp 31).

Phobia is also an anxiety disorder that is hereditary in most cases; in such cases, parents tend to be overly concerned and tend to caution their children on almost everything. For instance, they may insist that the child should not play in the rain since he will catch a cold, he should not watch television too much to avoid ruining his eyes, and they are always repeating the don’ts. As a result, the child views the world as a very dangerous place, hence developing a phobia. Nevertheless, this disorder is treatable through benzodiazepine tranquilizers among other prescribed medication, as well as therapy (Bourne, 2005, pp 42). Other types of anxiety disorder include panic disorder, social anxiety disorder, and obsessive-compulsive disorder.

Brief description of posttraumatic stress disorder (PTSD)

Posttraumatic stress disorder (earlier referred to as combat fatigue) can be caused by a terrifying experience in which harm was either caused or threatened to the patient. PTSD was diagnosed by soldiers who suffered from traumas after wars. Such experiences may be natural disasters like the tsunami and accidents. Patients with PTSD normally have memories of these events, which disturb them emotionally and mentally. They also experience problems in sleeping and often want to be alone.

According to Edwards (2011), PTSD appears in 7-8% of people especially in rape victims and in teenagers who have experienced their parents being killed or community violence. The article further adds that those people who are addicted to smoking marijuana and taking alcohol normally develop PTSD. The main symptoms of this disorder are reoccurring traumas like flashbacks and nightmares and memories. The patient normally develops a phobia of some places and avoid them especially if they are a constant reminder of the trauma. Constant anger and blackouts are common, and in severe cases, a person may attempt suicide.

Used therapy approaches and their effectiveness

Recommended medication

According to Bourne (2005, pp 42), Benzodiazepine tranquilizers, which include Ativan and Klonopin are proven to be effective in treating anxiety disorders, as proof shows that there is a system of the brain that is sensitive to this medication. Hence, when gamma-aminobutyric acid (GABA) is induced to the patients, their anxiety decreases. Prazosin used in PTSD cases has also been proven effective.

Therapies used and their effectiveness

In the case of treating posttraumatic stress, the psychotherapy technique is used, which involves educating the patients on the disorder, and what they should expect in the treatment process. This technique is designed to minimize myths about the disorder and the shame associated with it in patients, hence assisting them in coping with the disorder and managing their anger and anxiety. Another therapy involves the eye movement desensitization and reprocessing (EMDR), whereby, the patients speak of his ordeal while looking at the professional’s finger which moves rapidly. This method has been proven effective as it reduces.

According to Walser (2007, pp 18), the use of acceptance and commitment therapy (ACT) is effective in treating a case of post-traumatic stress disorder, which entails the patients to experience positive and negative events without treating them as reality. The patient learns to view traumas differently and that they are no longer a danger to them; he can distinguish between reality, allusions, and reactions. The virtual reality exposure therapy for treating anxiety disorders has proven to be effective.

It involves exposing patients to those traumas that they are afraid of, in an imaginative way, or agoraphobia. This therapy tends to justify that when a person has been exposed to his fears long enough, the patient will have nothing to fear in the end. After the process of been exposed, the patient then undergoes habituation, which finally subsidizes the anxiety. It entails the patients’ capability of facing their fears other than escaping them (Brahnam, 2011, pp 47).

Measurement devices used for the diagnosis of post-traumatic stress disorder

According to Bertram and Dartt (2008 pp 297), posttraumatic stress in solders resulted from traumas in the war zones. However, today, such stressors are evident in youths as they struggle to live in poor conditions, threats of being attacked, lack of food, lack of privacy and violence, in their communities. This is in comparison to the veterans in Iraq who experience PTSD, due to the effect of the war such as witnessing their fellow soldiers being murdered and their capabilities of killing the enemy. The same case goes for the youth who witness a lot of violence in their communities.

The PTSD is evident in the condition of the soldiers such as loss of limbs and eyesight, and disfigurement, which remain permanent, hence a constant reminder of the traumatic events. According to the author in 2002, 3,365 death of youths were reported and 16,000 with minor injuries. The same case applies to the United States military in Iraq who in five years, 4,115 were reported dead and 30,000 wounded. Bremner et al, (1993, pp 1016) illustrates a case of a patient group of 26 veterans who suffered from PTSD. This research was conducted at the National Center for PTSD, whereby, a consensus diagnosis was carried out by three researchers.

First, check on their background information, neither of the soldiers had a history of brain injury or alcohol abuse. Also, the 26 patients had no history of loss of consciousness; however, this was evident at the time of admission. The other group of 15 being used as a comparison to the veterans included healthy workers especially from the construction sites who had never been involved in wars or combat exposure. These groups compromised of men only and they were matched to the patients with PSTD in terms of age, health, and fitness. The two groups were tested on memory, alcohol intake, and reminding tests and differences in scores were evaluated.

However, the results showed that the PTSD soldiers had the same level of intelligence in terms of memory and scored 36% poorly compared to the comparison group. In conclusion, this research conveyed that the PTSD patients scored poorly in all the areas of tests, 44% lower in memory, and 55% lower in recalling. This finding used the neuropsychological testing and through intelligence tests, comparing the two groups diagnosed how severe PTSD in the soldiers was.

Research article summary

According to McLay, Wood, Webb-Murphy, Spira, Wiederhold, Pyne, and Wiederhold (2011, pp 224), the article states that PTSD has been a problem associated with the soldiers who come back from Iraq, with the increase of the number of troops being sent to Iraq. The government has introduced a randomized trial on PTSD on troops based in Iraq and Afghanistan; these trials have proved to be effective in the exposure therapy for PTSD. These exposure therapies are designed to confront the fears rather than avoiding them, mainly through talking about the traumatic events, thus confronting the anxiety within.

Virtual reality-graded exposure therapy (VR-GET) is the latest therapy that does not focus on prolonged exposure. This therapy combines physiologic monitoring and skills training, designed for an individual to be able to confront his fears and memories. This therapy is advantageous in that, the affected patient can learn skills that he can apply in anxiety situations. According to McLay et al (2011, p. 224), “patients are trained to recognize and control excessive autonomic arousal and cognitive reactivity, thus allowing them to confront difficult memories, intrusive thoughts, and feelings throughout the therapy.”

To prove how VR-GET is effective, a study was conducted for the trial of this therapy. This study was experimental and involved treatment versus a control condition, in which the participants would continue receiving treatment for the disorder. The success of this treatment would be gauged on its capability to reduce 30% of the PTSD symptoms in 10 weeks. The location was the naval medical center in San Diego, while the participant comprised of active duty members who had been diagnosed with PTSD, as a result of their mission in Iraq and Afghanistan.

Ten participants were selected on each team, one on the TAU and the other on VR-GET treatment. The VR participants met the therapist twice a week for 10 weeks. The first section included detail of the participants on trauma history. They were then educated on control and attention and then issued with a relaxing CD. During the first two sections, they were required to share their stories and symptoms. The participants in the 3rd session were exposed to a similar situation as those in Iraq, through 3D visual scenarios, mimicking the sounds of war.

This was done to ensure that they gained full control of their fears by facing them and at the same time practicing attention and control. The participants on TAU received “group therapy, cognitive behavioral therapy, eye movement desensitizations, and reprocessing, and psychodrama” (McLay et al, 2011). The results were based on VR-GET vs. TAU treatments, from which the treatment would attain a 30% reduction in PTSD.

All participants had fully participated in the study; however, TAU patients attended 14 visits in 10 weeks. While VR-GET patients attended 11 health visits and 8 of which were for VR-GET treatment. Results showed that up to 70% of the participants who received VR-GET indicated a 30% progress in the PTSD symptoms after the required 10 weeks. As compared to TAU, patients showed 12.5% progress in their treatment; VR-GET proved to be effective as it challenged its patients to confront their fear others that shun away.

In conclusion, it is evident that the troops in Iraq and Afghanistan would benefit more from the VR-GET and their situations would improve than in the use of TAU. Nevertheless, this was just an experimental study and it proved the effective treatment for the PTSD. This article provides a relief to PTSD conditions, as researchers continue the research to find an even more effective treatment.

References

Bertram, R. and Dartt, J. (2008). Post Traumatic Stress Disorder: A Diagnosis for Youth from Violent, Impoverished Communities. Journal of Child & Family Studies, Vol. 18 Issue 3, p294. Springer science publishers. Web.

Bourne, E. (2005). The anxiety & phobia workbook. Edition 4. CA: New harbinger publications.

Brahnam, S. (2011). Advanced Computational Intelligence Paradigms in Healthcare 6: Virtual Reality in Psychotherapy, Rehabilitation, and Assessment. Berlin: Springer Publishers.

Bremner, J. et al. (1993). Deficits in short-term memory in post-traumatic stress disorder. Journal of Psychiatry, Vol. 150, Pp. 1015-1019. Web.

Edwards, R. (2011). . National Institute of Mental Health. Web.

McLay, R. N., Wood, D. P., Webb-Murphy, J. A., Spira, J. L., Wiederhold, M. D., Pyne, J. M., and Wiederhold, B. K. (2011). A Randomized, Controlled Trial of Virtual Reality-Graded Exposure Therapy for Post-Traumatic Stress Disorder in Active Duty Service Members with Combat-Related Post-Traumatic Stress Disorder. Cyberpsychology Behavior Social Network, Vol. 14, No. 4, Pp. 223-229. Web.

Walser, R. and Westrup, D. (2007). Commitment Therapy for the Treatment of Post-Traumatic Stress Disorder & Trauma-Related Problems: A Practitioner’s Guide to Using Mindfulness & Acceptance Strategies. CA: New Harbinger Publications.

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