Post Traumatic Stress Disorder and the Brain, Research Paper Example

Abstract

The most common factor in the development of PTSD is sexual abuse. There are treatment methods available to those who suffer from PTSD such as VR-GET, medication, counseling and holistic approaches. There is currently no cure for PTSD and it can last anywhere from a few months to an entire lifetime. Those who suffer from a lifetime of PTSD require the most treatment and care as well as patients who have pre-existing mental conditions such as bipolar, ADHD, schizophrenia and other mental illnesses.

Post Traumatic Stress Disorder and the Brain

There is a great deal of scientific literature available on the etiology and effects of Post Traumatic Stress Disorder (PTSD) dating back to the 19th century. “Returning Franco–Prussian war veterans were observed in hospital wards by a neurologist, Jean–Martin Charcot who identified a cluster of symptoms including exhaustion, anxiety, heart palpitations, chest pain, trembling, and disorientation, that emerged well after exposure to the violence, dislocation, and physical wounds of the war.” (Bertram & Dart, 2009) “Post-traumatic stress disorder, also known as PTSD, was initially considered an axiety disorder that was isolated only to wartime trauma. Today, however, PTSD is associated with a variety of psychological results, stemming from events such infant death and miscarriages, near death experiences (i.e. car crash), sexual abuse, natural disasters and victimization (Jaffe & Schub, 2011)

There are a number of additional factors to consider such as history of mental illness, severity of the traumatic event, and at what point in a person’s life the trauma occurred. Not everyone who experiences traumatic events will develop PTSD or have the same symptoms. PTSD varies in severity depending upon the biological and environmental factors involved in its development. According to Psychological Medicine (2011), differences in trauma risks are often the result of the event as well as factors directly related to race and demographics.  A study conducted by Psychological Medicine (2011) found that Caucasians, more than other racial group suffer trauma or become aware of trauma from other family members while African Americans and Hispanics experienced higher risks due adolescent maltreatment (i.e. domestic violence). Among all races exposed to traumatic events, African Americans indicated slightly higher risk factors (Roberts, Gilman, Breslau, Breslau and Koenen, 2011).

Common Causes (War, Natural Disaster, Domestic Abuse, and Homelessness)

There are a small handful of common scenarios that can increase one’s chance of developing PTSD. One of the first cases is war and because there are a handful of wars that United States is currently involved in at present, several studies have been able to utilize the help of active duty military servicemen and women to aid in the research of PTSD in the military. “…the wars have now been ongoing since 2001, and that by 2008 over 1.6 million American troops had deployed to Iraq and Afghanistan, there has been only one randomized, controlled, proof-of-concept study for Active Duty Service Members with PTSD, and that was conducted in survivors of the September 11 attacks on the Pentagon. Before this report, there were no randomized trials for PTSD in Active Duty Service Members who served in Iraq or Afghanistan.” (McLay et al, 2011) The nature of these wars, while highly controversial, has contributed a variety of findings to the field of PTSD research. This particular study concludes that virtual reality is an effective treatment option for many active duty military personnel who are currently suffering from PTSD.

TAU stands for treatment as usual while VR stands for virtual reality. According to McLay et al. “The findings here indicated that Service Members with PTSD related to service in Iraq or Afghanistan were more likely to improve if they received VR-GET than if they received TAU.” VR-GET treatment has been proven successful for many military-related cases of PTSD. Whether or not it proves successful for civilian patients is something that remains to be seen.

War is not the only environmental cause of PTSD. Another factor is being involved in a natural disaster such as an earthquake, tsunami, or hurricane. Victims of Hurricane Katrina in 2005 and more recently, many of the Japanese victims of the tsunami and nuclear crisis in Japan have are at an increased risk of suffering from PTSD. Natural disaster victims, faced with the displacement of their families and communities, and often dependent upon government or foreign aid during times of crisis, are left vulnerable to the many ravages that ensue after a natural disaster takes place. They are often uprooted from their homes, losing all of their material possessions, their jobs, and even members of their families such as children, spouses, and pets.

Women and children suffering from domestic violence are also at an increased risk of developing PTSD. (Bertram & Dartt, 2009) Sexual and physical abuse can play a large role in the development of PTSD. In fact, sexual abuse is the leading cause of the development of PTSD among both men and women (Bertram & Dartt, 2009). Prolonged homelessness can also be a cause for PTSD as well as several other types of mental illnesses. Prolonged homelessness is homelessness that lasts for several months or even several years. Depression and PTSD are common among the homeless population. (Bertram & Dartt, 2009)

Finally, severe motor vehicle accidents can contribute to the development of PTSD. “More than 50 million people each year are injured in the road traffic system worldwide, and nearly one-third of the injured patients appear to develop trauma-related psychiatric illnesses such as post-traumatic stress disorder (PTSD). PTSD has been associated with higher psychiatric comorbidity, attempted suicide, physical illnesses such as asthma, hypertension, and peptic ulcer, as well as high health-care costs.” (Nishi, 2010)

Biological Factors

There are some biological factors that can affect the development of PTSD. One of these factors is a history or prevalence of a mental illness such as bipolar disorder. “Traumatic experiences are frequent in patients with severe mental illness. Garno et al. [9] reported on severe childhood trauma in approximately half of a sample of patients with bipolar disorder. Furthermore, studies of bipolar disorder patients reported on a relationship between child abuse and neglect and an earlier onset of the illness, severity of mania, number of manic episodes, clinical course and higher rates of suicide attempts” (Assion et al 2009) Bipolar disorder is characterized by cycles of high and low moods. Some cases of bipolar are mild while others are severe. Still, PTSD can complicate and in some cases, worsen the cases of those who are already suffering from bipolar disorder. “However, subgroup analysis has demonstrated higher rates of PTSD in patients with complicated mild traumatic brain injury.” (Jafee & Meyer, 2009)

Schizophrenia is generally characterized by instability in moods. However, unlike bipolar disorder those who are schizophrenic can hear voices, see images that are not there, and suffer from full-on hallucinations. Also, schizophrenia can also cause one to have a lack of feelings or empathy in situations that require it. Severe schizophrenia prevents a person from being able to function in the real world without treatment. PTSD can complicate a condition, often because those who are schizophrenic develop it in their early 20s – significantly later than most other mental illnesses which are generally developed during childhood.

Another mental illness that can aid in the development of PTSD is alcoholism. “Among alcohol-dependent inpatients 32.1% were considered as having lifetime PTSD. Mean scores of alexithymia, novelty seeking (NS), harm avoidance (HA) and self-transcendence (ST) were higher in the PTSD group, whereas age and self directedness (S) were lower. Among age and other factors of TAS-20, ‘difficulty in identifying feelings (DIF)’ predicted PTSD in a logistic regression model.” (Evren, 2010) It is important to note that treating the alcoholism does not necessarily treat the PTSD. PTSD can still remain even if someone is being treated or has successfully been treated for alcohol dependency. Alcohol-dependent inpatients require specific treatments that deal with each individual issue and careful monitoring to determine whether or not the treatments are working.

The chemical processes in the brain that affect the development of PTSD often occur in the pre-frontal cortex. This is why head injuries, domestic violence, and sexual abuse which often encompasses physical violence, are likely to lead to the development of PTSD. “Studies have begun to identify alterations in default mode network activity during the resting state in psychiatric disorders, including major depression (4), posttraumatic stress disorder (PTSD) (5), schizophrenia (6–8), autism (9) and attention deficit hyperactivity disorder (10)” (Lanius, 2010)

Possible Treatments

Treatment for PTSD varies from patient to patient. One treatment that has been used primarily on war veterans from the Iraq and Afghanistan wars is the VR-GET treatment, also known as virtual reality graded exposure therapy. Other treatments include a combination of counseling and medication, holistic and alternative methods such as hypnosis and other treatments that are currently being tested. Because of the varying nature of PTSD, there is no uniform consensus on what constitutes efficacy in treatment as every patient will respond differently to each one. Medical professionals must continue to work closely with patients to develop treatment methods that are right for them.

Conclusion

As more research and studies are conducted, physicians and mental health practioners look to pharmacotherapy and other various approaches to minimize or eliminate PSTD (Fletcher, S., Creamer, M & Forbes, D., 2010). There are a number of biological and environmental factors that can and do lead to the development of PTSD. Biological factors include pre-existing mental illnesses and other chemical reactions that occur in the pre-frontal cortex area of the brain. PTSD can develop at any age from virtually any traumatic event, although not all people that experience severe trauma will develop PTSD.

References

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Bertram, R., & Dartt, J. (2009). Post Traumatic Stress Disorder: A Diagnosis for Youth from Violent, Impoverished Communities. Journal of Child & Family Studies, 18(3), 294-302. doi:10.1007/s10826-008-9229-7

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Gilman, S., Breslau, J., Breslau, N. and Koenen, K. (2011, January 14). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological Medicine. 41(1): 71-83 [Electronic Version]

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