IN WAR VETERANS
Alwin Aanand Thomson
American Degree Program
SEGi College Penang
Posttraumatic stress disorder (PTSD) is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity, overwhelming the individual's ability to cope. As an effect of psychological trauma, PTSD is less frequent and more enduring than the more commonly seen acute stress response. Diagnostic symptoms for PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal—such as difficulty falling or staying asleep, anger, and hyper vigilance. Formal diagnostic criteria in DSM-IV-TR require that the symptoms last more than one month and cause significant impairment in social, occupational, or other important areas of functioning (American Psychological Association).
The diagnostic criteria for PTSD, stipulated in the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as:
A: Exposure to a traumatic event
This must have involved both (a) loss of "physical integrity", or risk of serious injury or death, to self or others, and (b) a response to the event that involved intense fear, horror, or helplessness (or in children, the response must involve disorganized or agitated behavior). (The DSM-IV-TR criterion differs substantially from the previous DSM-III-R stressor criterion, which specified the traumatic event should be of a type that would cause "significant symptoms of distress in almost anyone," and that the event was "outside the range of usual human experience."
B: Persistent re-experiencing
One or more of these must be present in the victim: flashback memories, recurring distressing dreams, subjective re-experiencing of the traumatic event(s), or intense negative psychological or physiological response to any objective or subjective.
C: Persistent avoidance and emotional numbing
This involves a sufficient level of:
• avoidance of stimuli associated with the trauma, such as certain thoughts or feelings, or talking about the event(s); • avoidance of behaviors, places, or people that might lead to distressing memories; • inability to recall major parts of the trauma(s), or decreased involvement in significant life activities; • decreased capacity (down to complete inability) to feel certain feelings; • an expectation that one's future will be somehow constrained in ways not normal to other people.
D: Persistent symptoms of increased arousal not present before
These are all physiological response issues, such as difficulty falling or staying asleep, or problems with anger, concentration, or hypervigilance.
E: Duration of symptoms for more than 1 month
If all other criteria are present, but 30 days have not elapsed, the individual is diagnosed with Acute stress disorder.
F: Significant impairment
The symptoms reported must lead to "clinically significant distress or impairment" of major domains of life activity, such as social relations, occupational activities, or other "important areas of functioning". (DSM-IV-TR, American Psychiatric Assocation)
3.0 PTSD IN WAR VETERANS
3.1 Facts & Figures
Operation Iraqi Freedom has become the deadliest American military conflict since the Vietnam War. Uto 13 percent of the troops returning from the deployment have reported symptoms of post-traumatic stress disorder (PTSD). With the daily violence in this war torn country, service men and women are subjected to...