Posttraumatic stress disorder (PTSD) is gradually becoming one of the most prevalent psychological conditions affecting humans. This condition was chosen for several reasons. Firstly, the number of individuals who receive a PTSD diagnosis continues to increase. Secondly, PTSD is commonly associated with traumatic experiences, but it is important to understand what changes the human brain undergoes in response to trauma and how these physiological changes predispose individuals to PTSD risks. Thirdly, readers should understand that PTSD is treatable: contemporary researchers and clinicians propose a whole range of treatment options to help individuals with PTSD improve their health and wellbeing. Overall, the purpose of this paper is to review the current research related to PTSD in the field of psychology.
Posttraumatic stress disorder (PTSD) is affecting the growing number of people. According to the American Psychological Association, it is a mental health disorder that develops in response to physical or emotional trauma. For an individual to develop PTSD, he or she should not experience the traumatic event; quite often, it is enough to witness it (APA, “PTSD: For Patients and Families”). In all cases, traumatic events pose a serious psychological, emotional and physical threat (APA, “PTSD: For Patients and Families”). This threat is probably the main event triggering the development of PTSD. The American Psychological Association suggests that PTSD develops in individuals who have witnessed or survived natural disasters, catastrophes or accidents, acts of terror, and other tragedies (“PTSD: For Patients and Families”). The way PTSD manifests and the severity of its symptoms will vary depending on numerous factors such as the nature and consequences of the traumatic event, individual predisposition to emotional issues, a history of mental health disorders, and others.
Most clinicians look for several prominent symptoms, which distinguish PTSD from other mental health disorders. The American Psychological Association lists them all. Firstly, it is the recurrent character of traumatic memories (APA, “PTSD: For Patients and Families”). It means that a person who has faced a traumatic event cannot forget it. These recurrent memories have particularly negative impacts on the daily routines of affected individuals. At times, it is enough to see a traffic jam to recall a car accident that could have easily become fatal. Such memories can be so intrusive that they do not leave enough space for work, family life, socialization and other activities. Secondly, in PTSD, avoidance of trauma reminders is also prominent (APA, “PTSD: For Patients and Families”). Individuals with PTSD try avoid the situations or people that remind them of trauma (APA, “PTSD: For Patients and Families”). This is also an issue. For example, a young man cannot simply quit driving just because he has nearly avoided death in a car accident.
Thirdly, an individual with PTSD experiences a whole variety of negative emotions, which can also be intrusive and disruptive. Pineles et al. confirm that negative emotions in the aftermath of a traumatic event are the key symptom of PTSD that distinguishes it from other disorders (635). These emotions can take a form of either psychological reactivity or continued emotional distress (Pineles et al. 636). A person can be sad most of the time (APA). A patient with PTSD can experience anger, uncontrolled aggression, or numbness (APA). PTSD compromises normal emotional reactions. For example, a woman who loved driving may no longer feel the same way after a car accident. The same woman may also experience a deep sense of guilt if the car accident led to injuries or fatalities (APA, “PTSD: For Patients and Families”). Finally, emotional arousal is common in PTSD (APA, “PTSD: For Patients and Families”). Individuals can present with the signs of irritability, impatience, as well as complaints related to impaired sleeping patterns, poor attention or concentration, or lack of control (APA, “PTSD: For Patients and Families”).
These symptoms are the starting point in the physical and mental health examination of a patient with suspected PTSD. Clinicians often face difficulties in relation to a PTSD diagnosis due to the vagueness of symptoms and its clinical presentation. Increased or unusual emotional reactivity to memories or emotional cues associated with a traumatic event can be helpful in making the final diagnosis (Pineles et al. 636). Lobo et al. also suggest that failure to regulate negative emotions due to recurrent memories of a traumatic event is a distinctive feature of PTSD (191). However, as Daniel R. Orme says, one cannot see or touch PTSD (397). Therefore, clinicians, psychologists and counselors have to rely on self-reported symptoms and subjective complaints with which patients present to them. However, many symptoms can be vague or misleading. Besides, it is not always possible to make a difference between normal and pathological symptoms (Orme 400). Although psychologists use different instruments and questionnaires to evaluate the complexity of PTSD symptoms in patients, making the final diagnosis is always a challenge. Causes of PTSD also deserve more research and analysis.
The results of neuroimaging studies provide the best fact-based information about the possible causes and processes involved in PTSD. However, these results are mixed and conflicting. Amygdala activation due to traumatic exposure is probably the most popular cause and explanation of PTSD (Lobo et al. 191). It is further accompanied by the inhibitory processes in the prefrontal cortex (Lobo et al. 191). This prefrontal cortex-amygdala circuit is central to effective emotional regulation in humans (Lobo et al. 191). The aforementioned processes undermine one’s capacity to regulate emotions in the aftermath of a traumatic event. Putting it simply, a traumatic event changes the way the human brain functions. PTSD is caused by hyper vigilance that develops in the aftermath of a traumatic event and does not decrease with time (APA, “PTSD: For Patients and Families”). These changes further define the nature and complexity of symptoms with which individuals present to clinical specialists.
Research of PTSD Treatment
Individuals with PTSD should hear two important messages. Firstly, PTSD can be treated and cured. Secondly, research provides rich evidence of effective treatments for PTSD. The American Psychological Association lists the following evidence-based treatments that are available to patients with PTSD: cognitive behavioral therapy, cognitive therapy, cognitive processing therapy, narrative exposure therapy, prolonged exposure therapy, and brief eclectic psychotherapy (“Clinical Practice Guideline”). Cognitive behavioral therapy (CBT) is probably the first-line therapy used in patients with PTSD. Its purpose is to help individuals change the direction and patterns of their behaviors and thoughts (APA, “Clinical Practice Guideline”). For example, CBT can be particularly helpful in breaking the associative links between traumatic memories and negative emotional responses to them (APA, “Clinical Practice Guideline”). In CBT, psychologists can encourage patients to revisit the traumatic event and their responses to it, thus reducing avoidance of traumatic cues and encouraging them to reconstruct their understanding of the trauma (APA).
If psychological or behavioral therapy does not help, individuals with PTSD may need to take medications. The American Psychological Association provides an exhaustive list of effective and safe medications for PTSD (“Medications for PTSD”). Paroxetine and sertraline are two selective serotonin reuptake inhibitors that can influence the activity of serotonin (APA, “Medications for PTSD”). The latter plays one of the key roles in the development of anxiety and mood disorders (APA, “Medications for PTSD”). Antidepressants such as venlafaxine can also be used (APA, “Medications for PTSD”). Walter Alexander in a review of randomized controlled trials also lists medications that are used for other mental health disorder as having a potential to reduce the symptoms of PTSD: quetiapine, risperidone, and olanzapine (36). Decisions as to the appropriateness and usefulness of medications for patients with PTSD should be made individually, on a case-to-case basis. In the presence of rich treatment options, even the most complicated symptoms of PTSD can be successfully eliminated.
PTSD is a serious mental health disorder. It develops in response to a traumatic event. Psychologists have a whole arsenal of behavioral and pharmacological strategies to help individuals with PTSD reduce their symptoms. The key message is clear: PTSD is treatable, and the existing treatments can benefit any person affected by it.
- Alexander, Walter. “Pharmacotherapy for Post-Traumatic Stress Disorder in Combat Veterans.” Physical Therapy, vol. 37, no. 1, 2012, pp. 32-38.
- American Psychological Association. “Medications for PTSD.” APA, 31 Jul 2017. http://www.apa.org/ptsd-guideline/treatments/medications.aspx. Accessed 1 Dec 2017.
- American Psychological Association. “PTSD: For Patients and Families.” APA, 31 Jul 2017. http://www.apa.org/ptsd-guideline/patients-and-families/index.aspx. Accessed 1 Dec 2017.
- American Psychological Association. Clinical Practice Guideline for the Treatment of PTSD. APA, 2017.
- Lobo, Isabela, et al. “The Neurobiology of Posttraumatic Stress Disorder: Dysfunction in the Prefrontal-Amygdala Circuit?” Psychology & Neuroscience, vol. 4, no. 2, 2011, pp. 191-203.
- Orme, Daniel R. “Diagnosing PTSD: Lessons from Neuropsychology.” Military Psychology, vol. 24, no. 4, 2012, pp. 397-413.
- Pineles, Suzanne L., et al. “Psychophysiologic Reactivity, Subjective Distress, and Their Associations with PTSD Diagnosis.” Journal of Abnormal Psychology, vol. 122, no. 3, 2013, pp. 635-644.