Detailed descriptionPost-traumatic stress disorder is a neurological, mental disorder. It occurs after exposure to traumatic events, for example, rape, near death experience, or serious injury. Researchers indicate that traumatic events exposure occurs in about 60 percent of the population. However, in the natural progression, the condition does not affect everyone (Javidi & Yadollahie, 2011).

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Diagnosis
DSM-V diagnostic criteria for PTSD includes the history of exposure to traumatic events and symptoms associated with the four clusters: alterations in reactivity and arousal, intrusion, avoidance, and negative mood and cognitions alteration. The stressor criterion contains threated or actual injury, direct or indirect exposure to death, and sexual violence symptoms. Intrusion criterion includes intrusive dissociative reactions, marked psychological reactivity, involuntary and recurrent memories, and nightmares. Avoidance symptoms include persistent and effortful response to stimuli that is trauma-related (Shiromani, Keane, & LeDoux, 2014).

Risk Factors
The risk factors of PTSD include genetics, lifestyle, and environmental factors. Heredity increases the likelihood of PTSD by about 30 percent. Children born of PTSD parents have a risk of about 50 percent. Environmental exposure, for example, work stress, and anxiety for military personnel is a risk factor. A lifestyle that exposes one to anxiety and high levels of stress increases the likelihood of PTSD. The level of trauma and the ability to deal with it determines the risk that it possesses to PTSD.

Other Causative Factors
People of various demographics are at risk of PTSD. Other causative factors apart from environment, genetics, and lifestyle include life threatening events, for example, accidents, long-lasting trauma experiences, childhood neglect or abuse, lack of good social support in times of trauma, and presence of other mental problems, for example, clinical depression and anxiety.

Nervous System Involvement
PTSD affects the ANS (autonomic nervous system), which is made of the parasympathetic nervous system (PNS) and sympathetic nervous system (SNS). Exposure to trauma triggers the SNS to release adrenalin, which is a fight or flight hormone under normal conditions. The symptoms of adrenalin release include high heart rate, sweating, and increased breathing. Prolonged stressors trigger both the PNS and the SNS, which leads to a shutdown of the system and tonic immobility. The effect is the symptoms of PTSD, which includes disregard of thoughtful processes, fear reduction, and painlessness among others (Krippner, Pitchford, & Davies, 2012).

Neurotransmitters
PTSD affects both thyroid and cortisol hormones. The hormones are essential in the hypothalamic-pituitary-adrenal axis (HPA) neurotransmitter system. Exposure to stress causes the paraventricular nucleus (PVN) to secret corticotrophin-releasing hormone (CHR) into the hypothalamo-hypophysical system, which stimulates the anterior pituitary to release adrenocorticotropic hormone (ACTH). ACTH causes glucocorticoids release, which modulates metabolism and brain function to facilitate appropriate organism behavior. PTSD impairs the functions of the above neurotransmitters altering the brain impulse to stress (Shiromani et al., 2014).

Treatment
Treatment of PTSD includes a combination of pharmacological and non-pharmacological options. Drug therapies include antidepressants to help with depression and anxiety, and selective serotonin selective inhibitors, for example, sertraline and paroxetine to manage the mood and depression. Non-pharmacological methods include cognitive behavior therapy and Eye movement desensitization and reprocessing (EMDR) therapy (SURGEON, 2015). The management team includes nurses, pharmacists, physicians, and physiotherapists. The setting of the management depends on the severity of the symptoms. Sever symptoms are best managed in a hospital setting while less severe systems are managed at home, with follow-up.

Future Research
Future areas of research include study to understand the normal progression, causes, and the biology of the condition. Other areas of future research, for example, the improvement of diagnostic and evaluation methods, treatment criteria for children and adults, and increase in knowledge to understand etiology are essential.

    References
  • Javidi, H., & Yadollahie, M. (2011). Post-traumatic stress disorder. The International Journal of Occupational and Environmental Medicine, 3(1 January). Retrieved from http://theijoem.com/ijoem/index.php/ijoem/article/view/127
  • Krippner, S. C., Pitchford, D. B., & Davies, J. A. (2012). Post-traumatic stress disorder. ABC-CLIO. Retrieved from https://books.google.com/books?hl=en&lr=&id=ySGQxqkgUpQC&oi=fnd&pg=PP2&dq=post-traumatic+stress+disorder&ots=gsR0MKF33k&sig=b1LKiRXSTcp_60qjW_w4A1XP1hE
  • Shiromani, P., Keane, T. M., & LeDoux, J. E. (2014). Post-traumatic stress disorder. Springer. Retrieved from http://link.springer.com/content/pdf/10.1007/978-1-60327-329-9.pdf
  • SURGEON, P. (2015). POST–TRAUMATIC STRESS DISORDER. The Encyclopedia of Civil War Medicine, 250. Retrieved from https://books.google.com/books?hl=en&lr=&id=WWZsBgAAQBAJ&oi=fnd&pg=PA250&dq=post-traumatic+stress+disorder&ots=kl9RU20kzd&sig=0e52ITrQQwPwGPWwGY8Kqg8Do54