Introduction
What Post-Traumatic Stress Disorder (PTSD) Does
PTSD is one of the most debilitating mental disorders developed when a person experiences or witnesses a life-threatening event. It is characterized with re-experiencing the symptoms, avoiding situations that bring the event into remembrance, elevated sense of negative beliefs and feelings, and hyper-arousal (Sabic et al.). A person suffering from PTSD becomes impaired socially, physically, psychologically, emotionally, and even occupationally (Belrose et al.). Some people may suffer from other comorbid conditions including substance abuse disorders, depression, and general physical health effects (Sabic et al.). For one to be diagnosed with PTSD, they must have experienced the symptoms for not less than a month. If the symptoms persist for more than three months, then the PTSD is considered as a chronic disorder.
What PTSD Is Not
There are many other mental health issues which people can suffer from which are not PTSD. They include conditions including acute stress disorder, anxiety and depression. It is important that PTSD has important characteristics that one must have experienced a traumatic episode to have it. Soldiers in combat face many challenges which leave them psychologically wounded. While some may recover from such experiences, others tend take long, while some may never recover at all.
PSTD Synonyms and Etymology
Post-traumatic stress disorder (PTSD) is a mental health condition that has been frequently observed in veterans and soldiers (Sabic et al.). Its synonyms include battle fatigue combat neurosis, war neurosis, combat disorder, or shell shock. The term came into use in the 1970s due to the diagnoses of U.S. military veterans of the Vietnam War and was officially recognized by the American Association of Psychiatric Association in 1980 through the third edition of its Diagnostic and Statistical Manual Disorder.
Details about PTSD
The prevalence of PTSD in Europe ranges between 1 and 7% (Belrose et al.). However, when emphasis is placed on identifying factors explaining individual differences in response to trauma and exhibition of resilience, the prevalence gets a bit. The range for trauma specific PTSD 25% to 50%, showing PTSD prevalence in military settings depends on the level and type of violence in the mission (Belrose et al.). Higher exposure to combat, therefore, yields higher prevalence of PTSD which can reach 20% (Belrose et al.). Even if appropriate care is given, efficient treatment is variable with about 20% of patients failing to respond to most psychological therapies (Belrose et al.). Little research has been done to determine the therapies which are most effective for specific patients. However, a 20 year longitudinal study involving a cohort of 2014 veterans revealed how initial combat stress reaction (CSR) can cause volatile stress with about 40% of patients who have recovered relapsing within a year of remission (Belrose et al.). These figures underscore the seriousness of PTSD among veterans and calls for proper handling of war veterans.
Other Concepts Related to PTSD
Reintegration
According to Elnitsky et al., reintegration can be defined in different ways. For instance, the U.S. Department of Veterans Affairs (DVA) defines it as the process of resuming gender, age, and culturally appropriate tasks and roles in the workplace, community, and family. It entails the process through which an individual transitions back into organizational or personal roles after being deployed. Others have also described it as the dynamic process of adapting, which is persona, multidimensional, and culturally personal (Elnitsky et al.). For others, community integration entails the return of an individual to his or her role functions, and their eventual to their life roles, they begin to participate in life. Most of the time, integration is conceptualized as a positive series of events, but for veterans, it can be a time for personal stress and difficulty due to PTSD. When a soldier returns from deployment, they may experience increased tension at an individual, family, or work level. Also, some veterans may experience exacerbation of stress conditions related to their deployment.
Transition
There are other related terms which are closely related to re-integration including transition and readjustment. Transition is generally used to denote the period or process through which a veteran moves from a military set up to a civilian set up. It can also be used to refer to the movement of a veteran through different systems of healthcare. There are times when phrases like the “transition to veteran status” are commonly applied; mostly emphasizing movement across or into institutional systems, for example the Department of Veterans Affairs (Elnitsky et al.). The term can also be used to describe the services provided to the war veterans.
Readjustment
Readjustment on the other hand, refers to the process through which a war veteran readapts to civilian life after deployment. Just like in transition, readjustment entails setting aside military roles and taking up the civilian ones. However, unlike transition, readjustment mostly evokes the realities of a war veteran struggling with emotional or psychological issues, including PTSD. This term has been used when referring to social and psychological health issues in a wide range of life roles like work, education, health and interpersonal relationships. They look at issues like marital and family life, financial difficulties, work issues, homelessness, motor vehicle accidents, and medical problems, among others. The term has also been used in specific service program titles for example Readjustment Counseling Service-U.S. Veteran Programs, 2015, and in reference to the economic and education benefits for example in Servicemen’s Readjustment Act of 1944, popularly referred to as the G.I Bill (Elnitsky et al.). The term is also used in the National Vietnam Veterans’ Readjustment Study (NVVRS), which looks into PTSD prevalence among Vietnam Veterans (Elnitsky et al.). In other contexts, this term can be used without a particular reference to any specific thing, for example readjustment to civilian life.
Predisposing Factors to PTSD
One of the issues that have been identified to be factor leading to PTSD is the intensity of combat exposure during military operations (Armenta et al.). Among the combat areas that have been identified to having been riddled with intense violence include Iraq and Afghanistan. This finding is consistent with those of Masters and Van Pelt who reviewed several scholarly studies concerning the factors that predispose soldiers to PTSD and summarized them. The researchers identified traumatic experiences during combat including the constant threat to life, the threatening sounds and gruesome sights of war as the factors that contribute to persistent PTSD among soldiers. These war zone stressors have been found to lead to the development of PTSD over time. On the other hand, soldiers who were deployed without engaging in combat were more likely to screen negative for PTSD at follow –up when compared with their counterparts who were deployed (Armenta et al.). Armenta et al. (2018) concluded that this observation of protective association among these non-combatant deployers was likely caused by the healthy warrior effect. The healthy warrior effect entails healthier service members being more likely to deploy than service members experiencing medical issues.
Apart from combat intensity, researchers have identified other risk factors for chronic PTSD, particularly physical and psychological health comorbidities. According to the findings of Armenta et al. (2018), comorbid conditions like depression or multiple physical symptoms can increase the risk of persistent PTSD. They have the potential of increasing the dysregulation of neuroendocrine and interoceptive functions or autonomous nervous system. Researchers have also linked the comorbid conditions to changes in pain perception or physical symptoms that act like reminders of the traumatic experience. This happens indirectly via the physiological mechanism associated with bodily sensations or directly from the injury that accompanied the traumatic experience. For this reason, it becomes very difficult to effectively treat and take care of soldiers or veterans with other additional conditions.
Another factor that has been identified to be predisposing soldiers and veterans to PTSD is sleep deprivation. One research noted that participants who reported to having slept for less than four hours per night had high chances of positively screening for PTSD, indicating that sleep is a vital predictor of persistent PTSD (Armenta et al.). Notably, sleep problems are common among service men in combat (Sabic et al.). Those who experience normal sleep disruptions after traumatic events have higher chances of developing PTSD (Armenta et al.). There are also cases where PTSD symptoms can cause sleep problems like recurrent nightmares, and hypervigilance. It is also known that sleep problems are related with comorbid conditions. This multiple interrelationship in health associations calls for a comprehensive approach to address the sleep problems, physical health problems, and chronic pain.
A vital aspect of PTSD therapy is having sufficient social support. When a person is bothered by many things because they do not have someone to turn to, their PTSD is most likely to persist. Social relationships are crucial in helping a person comply with therapy, cope with intrusive symptoms, and share the thoughts and feelings they experience during PTSD episodes. It has been noted that soldiers who have social support during and after deployment are less likely to suffer from severe PTSD (Armenta et al.). On the other hand, separation or retiring from active service led to persistent PTSD, an observation which is consistent, partly, with change in social relationships when a person transitions from the military. In some cases, persistent PTSD can also lead to medical discharge from the military for some individuals.
Another risk factor to PTSD is the age at which people are drafted into the military. One study found out that participant born before 1980 had higher chances of suffering persistent PTSD (Armenta et al.). Even though most military studies have shown that the risk of developing PTSD is higher in younger age groups, chronic PTSD is higher in older people. Among war veterans and Holocaust survivors, it has been reported that PTSD becomes severe with old age.
Conclusion
To sum it, if unresolved, PTSD becomes chronic leading to anguish and suffering in the victim, and those they closely associate with including their loved ones. Because of the high prevalence of PTSD, particularly in the military, there is an urgent need to formulate therapies that can effectively improve recovery of victims (Sabic et al.). An integrated system should be established to help with the intake of chronic PTSD patients. The system should be able to evaluate the impact of PTSD on the impairment of academic and occupational functioning. The systems should also be able to evaluate PTSD’s impact on family and marital functioning, parenting, socialization, and friendships. These impairments are common place among soldiers serving in combat overseas, particularly cases of chronic military PTSD. They can lead to unemployment and homelessness.
Annotated Bibliography
Armenta, Richard F., et al. “Factors Associated with Persistent Posttraumatic Stress Disorder among U.S. Military Service Members and Veterans.” BMC Psychiatry, vol. 18, no. 1, 2018.
This scientific study entailed twelve years of study involving 2409 participants. The data was collected approximately every three years, making it one of the longest and most detailed studies on PTSD among veterans. The article has been accessed more than 18000 times, with 59 citations. The researchers have cited 53 studies to support their research, attesting to their depth of work. The lead researcher is Richard Armenta, an experienced military officer who has works at the Deployment Health Research Department, of the Naval Health Research Center.
Belrose, Célia, et al. “Challenges Associated with the Civilian Reintegration of Soldiers with Chronic PTSD: A New Approach Integrating Psychological Resources and Values in Action Reappropriation.” Frontiers in Psychiatry, vol. 9, no. 737, 2019.
This paper was a prospective study that focused on examining PTSD severity and psychological resources before and after a rehabilitation program to determine the impact of Values in Action Reappropriation (VIA) on successful reintegration of veterans into civilian jobs. The study thoroughly examined the available literature with the necessary rigor for a proper scientific paper. The researchers involved in this study are accomplished scientists who are active in different scientific departments in diverse institutions around the world include Faculty of Health of the Australian Catholic University Melbourne, and Universite de Lorraine, in France, among other reputable institutions. The researchers made use of detailed and properly illustrated figures in explaining the rehabilitation process of the French military, from reinsertion to rehabilitation.
Elnitsky, Christine A., et al. “Military Service Member and Veteran Reintegration: A Conceptual Analysis, Unified Definition, and Key Domains.” Frontiers in Psychology, vol. 8, 2017.
This study entailed a meta-analysis of studies about returning service members and veterans and focused on how they defined key terms like reintegration, transition, readjustment and coping, and community integration. This meta-analysis was very comprehensive, involving 1459 articles in health and social sciences spanning twenty five years from 1990. 117 articles were analyzed after they passed inclusion criteria. One of the strengths of this article is its detailed approach on definition of key terms like reintegration, readjustment, and transition among others. Its authors are faculty members in reputable institutions including University of North Carolina at Charllote and the University of Cincinnati, OH, USA.
Masters, Kim J. “Post-Traumatic Stress Disorder in Combat Veterans.” Journal of the American Academy of Physician Assistants, vol. 31, no. 11, 2018, pp. 11–11.
This article highlights the extent of PTSD, some of the evidence-based therapies, and the peculiar position of physician assistants (PAs) in taking care of military patients. The study involved Physical Assistants, with almost a third of them having some military experience, something which is important in studies involving PTSD in veterans. One of the suggestions of this research, which is vital for dealing with PTSD in veterans, is the need to form treatment alliances and support systems as part of public health measures in dealing with PTSDs.
Sabic, Dzevad, et al. “Embitterment in War Veterans with Posttraumatic Stress Disorder (PTSD).” Med Arch, 2017, pp. 125–130.
This experimental study analyzed the frequency of embitterment among veterans of war with PTSD. The study was detailed because it analyzed 174 participants, with 87 allocated for the experiment and 87 for the as control subjects. The findings of this study show that embitterment is frequent in veterans with PTSD. Apart from having figures and tables, the study cited current articles making its information relevant to its context. All the researchers are faculty members in the schools of Medicine in Universities in Bosnia, a region that has been ravaged by war.
Van Pelt , Rod. “Post-Traumatic Stress Disorder in Veterans Returning from Combat: Impact on Social Reintegration.” Purdue Undergraduate Research Conference, 2019.
This article reported a review of literature of the impact of PTSD on social integration of veterans coming from active combat. The major focus was the appraisal of the evidence adduced by different researchers and assessing the strength of the data supporting the answers to the various research questions. The articles chosen for the study were varying in their currency, ranging from 1999 to 2015. The author, Rod Van Pelt has published two articles, with the other one being on use of technology in education. It is, therefore, clear that Van Pelt may not be an expert in this field of PTSD. Also, the author did not involve other researchers in the work, which is good for increasing the rigor and depth of research.
Works Cited
Armenta, Richard F., et al. “Factors Associated with Persistent Posttraumatic Stress Disorder among U.S. Military Service Members and Veterans.” BMC Psychiatry, vol. 18, no. 1, 2018, Web.
Belrose, Célia, et al. “Challenges Associated with the Civilian Reintegration of Soldiers with Chronic PTSD: A New Approach Integrating Psychological Resources and Values in Action Reappropriation.” Frontiers in Psychiatry, vol. 9, no. 737, 2019, Web.
Elnitsky, Christine A., et al. “Military Service Member and Veteran Reintegration: A Conceptual Analysis, Unified Definition, and Key Domains.” Frontiers in Psychology, vol. 8, 2017, Web.
Masters, Kim J. “Post-Traumatic Stress Disorder in Combat Veterans.” Journal of the American Academy of Physician Assistants, vol. 31, no. 11, 2018, pp. 11–11., Web.
Sabic, Dzevad, et al. “Embitterment in War Veterans with Posttraumatic Stress Disorder (PTSD).” Med Arch, 2017, pp. 125–130., Web.
Van Pelt, Rod. “Post-Traumatic Stress Disorder in Veterans Returning from Combat: Impact on Social Reintegration.” Purdue Undergraduate Research Conference, 2019.