|
How is PTSD assessed?
In recent years, a great deal of research has been aimed at developing and testing
reliable assessment tools. It is generally thought that the best way to diagnose PTSD-or any psychiatric disorder,
for that matter-is to combine findings from structured interviews and questionnaires with physiological
assessments. A multi-method approach especially helps address concerns that some patients might be either denying
or exaggerating their symptoms.
How common is PTSD?
An estimated 7.8 percent of Americans will experience PTSD at some point in their
lives, with women (10.4%) twice as likely as men (5%) to develop PTSD. About 3.6 percent of U.S. adults aged 18 to
54 (5.2 million people) have PTSD during the course of a given year. This represents a small portion of those who
have experienced at least one traumatic event; 60.7% of men and 51.2% of women reported at least one traumatic
event. The traumatic events most often associated with PTSD for men are rape, combat exposure, childhood neglect,
and childhood physical abuse.
The most traumatic events for women are rape, sexual molestation, physical attack,
being threatened with a weapon, and childhood physical abuse.
About 30 percent of the men and women who have spent time in war zones experience
PTSD. An additional 20 to 25 percent have had partial PTSD at some point in their lives. More than half of all male
Vietnam veterans and almost half of all female Vietnam veterans have experienced "clinically serious stress
reaction symptoms." PTSD has also been detected among veterans of the Gulf War, with some estimates running as high
as 8 percent.
Who is most likely to develop PTSD?
1. Those who experience greater stressor magnitude and intensity, unpredictability,
uncontrollability, sexual (as opposed to nonsexual) victimization, real or perceived responsibility, and
betrayal
2. Those with prior vulnerability factors such as genetics, early age of onset and
longer-lasting childhood trauma, lack of functional social support, and concurrent stressful life events
3. Those who report greater perceived threat or danger, suffering, upset, terror,
and horror or fear
4. Those with a social environment that produces shame, guilt, stigmatization, or
self-hatred
What are the consequences associated with PTSD?
PTSD is associated with a number of distinctive neurobiological and physiological
changes. PTSD may be associated with stable neurobiological alterations in both the central and autonomic nervous
systems, such as altered brainwave activity, decreased volume of the hippocampus, and abnormal activation of the
amygdala. Both the hippocampus and the amygdala are involved in the processing and integration of memory. The
amygdala has also been found to be involved in coordinating the body's fear response.
Psychophysiological alterations associated with PTSD include hyper-arousal of the
sympathetic nervous system, increased sensitivity of the startle reflex, and sleep abnormalities.
People with PTSD tend to have abnormal levels of key hormones involved in the
body's response to stress. Thyroid function also seems to be enhanced in people with PTSD. Some studies have shown
that cortisol levels in those with PTSD are lower than normal and epinephrine and norepinephrine levels are higher
than normal. People with PTSD also continue to produce higher than normal levels of natural opiates after the
trauma has passed. An important finding is that the neurohormonal changes seen in PTSD are distinct from, and
actually opposite to, those seen in major depression. The distinctive profile associated with PTSD is also seen in
individuals who have both PTSD and depression.
PTSD is associated with the increased likelihood of co-occurring psychiatric
disorders. In a large-scale study, 88 percent of men and 79 percent of women with PTSD met criteria for another
psychiatric disorder. The co-occurring disorders most prevalent for men with PTSD were alcohol abuse or dependence
(51.9 percent), major depressive episodes (47.9 percent), conduct disorders (43.3 percent), and drug abuse and
dependence (34.5 percent). The disorders most frequently comorbid with PTSD among women were major depressive
disorders (48.5 percent), simple phobias (29 percent), social phobias (28.4 percent), and alcohol abuse/dependence
(27.9 percent).
PTSD also significantly impacts psychosocial functioning, independent of comorbid
conditions. For instance, Vietnam veterans with PTSD were found to have profound and pervasive problems in their
daily lives. These included problems in family and other interpersonal relationships, problems with employment, and
involvement with the criminal justice system.
Headaches, gastrointestinal complaints, immune system problems, dizziness, chest
pain, and discomfort in other parts of the body are common in people with PTSD. Often, medical doctors treat the
symptoms without being aware that they stem from PTSD.
How is PTSD treated?
PTSD is treated by a variety of forms of psychotherapy and drug therapy. There is
no definitive treatment, and no cure, but some treatments appear to be quite promising, especially
cognitive-behavioral therapy, group therapy, and exposure therapy. Exposure therapy involves having the patient
repeatedly relive the frightening experience under controlled conditions to help him or her work through the
trauma. Studies have also shown that medications help ease associated symptoms of depression and anxiety and help
with sleep. The most widely used drug treatments for PTSD are the selective serotonin reuptake inhibitors, such as
Prozac and Zoloft. At present, cognitive-behavioral therapy appears to be somewhat more effective than drug
therapy.
However, it would be premature to conclude that drug therapy is less effective
overall since drug trials for PTSD are at a very early stage. Drug therapy appears to be highly effective for some
individuals and is helpful for many more. In addition, the recent findings on the biological changes associated
with PTSD have spurred new research into drugs that target these biological changes, which may lead to much
increased efficacy .
|
Presented by:
Dr. Mike Shery is the director of
ACRSand is a licensed clinical psychologist. He has practiced
clinical psychology for approximately 30 years and is
affiliated with almost all health plans, including:
ValueOptions, Medicare, Cigna, Cigna Behavioral Health, United Health Care, Aetna, First Health,
Healthstar, Blue Cross Blue Shield of Illinois, ComPsych, Magellan Health, HFN, Tricare, Humana,
most union local plans, most school district plans, Unicare, ChoiceCare, CAPP, Multiplan, Mental
Health Network, Managed Health Network, PHCS, PPONext, Humana Military-Tricare, United
Behavioral Health and Beech Street.
He is board certified as a specialist in professional counseling by the International Academy of Behavioral
Medicine, Counseling and Psychotherapy. He a member of the American Counseling Association.
The office is located in Cary, IL, near Crystal
Lake and Algonquin, northern Kane County and in southern McHenry County. In select cases, phone
consultations are available for those who don’t live locally> Telephone
Counseling.
To make an appointment>New Patient
Registration or to learn more about the
psychological services he provides call him at 1-847-275-8236 (24 Hrs).
|
_____________________________________________________________________________________________________
______________________________________________________________________________________________________
To make an
appointment, schedule yourself now;
Click: Make appointment for Cary Office: Therapy and
Counseling
To return to: Motor Vehicle Accidents, Job Injuries and
PTSD
_______________________________________________________________
_
_______________________________
|